Organization
M MINNIEVILLE DENTAL CARE PLLC
Active
Parent organization
MOMENTUM DENTAL CARE
Other names
Momentum Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOMENTUM DENTAL CARE
Authorized official
GELLY RIVAS OSORIO (OPERATIONS MANAGER)
(703) 589-7040
Entity
Organization
Contact information
Practice address
14389 HEREFORD RD, WOODBRIDGE, VA 22193-2107
(703) 878-8000
Mailing address
4222 FORTUNA CENTER PLZ # 637, DUMFRIES, VA 22025-1515
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/07/2020
Last updated
02/17/2021
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