Individual
ELISAVET KONSTANTINIDOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12700 BLACK FOREST LN STE 300, WOODBRIDGE, VA 22192-5306
(703) 230-6784
Mailing address
12700 BLACK FOREST LN STE 300, WOODBRIDGE, VA 22192-5306
(703) 230-6784
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401417139
VA
Other
Enumeration date
06/28/2024
Last updated
06/28/2024
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