Individual
KENNETH QIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1110 ELDEN ST STE E108, HERNDON, VA 20170-5529
(703) 318-7200
(703) 318-8668
Mailing address
1110 ELDEN ST STE E108, HERNDON, VA 20170-5529
(703) 318-7200
(703) 318-8668
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
401102428
VA
1223G0001X
General Practice Dentistry
401410257
VA
1223G0001X
General Practice Dentistry
Primary
401410740
VA
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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