Organization
FAIRFAX ADVANCED DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX OSINOVSKY (OWNER)
(703) 861-8777
Entity
Organization
Contact information
Practice address
3930 PENDER DR STE 150, FAIRFAX, VA 22030-0986
(703) 650-9299
Mailing address
3930 PENDER DR STE 150, FAIRFAX, VA 22030-0986
(703) 650-9299
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/23/2019
Last updated
01/23/2019
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