Individual
CHARLES DOUGLAS KIRKSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10611 JUDICIAL DR, FAIRFAX, VA 22030-5165
(703) 385-0303
(703) 385-1445
Mailing address
10611 JUDICIAL DR, FAIRFAX, VA 22030-5165
(703) 385-0303
(703) 385-1445
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005454
VA
Other
Enumeration date
04/23/2008
Last updated
09/15/2016
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