Individual
ELAINE K. SOURS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
8719 PLANTATION LN, MANASSAS, VA 20110
(703) 369-5544
(703) 361-3680
Mailing address
8719 PLANTATION LN, MANASSAS, VA 20110-4506
(703) 369-5544
(703) 361-3680
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005467
VA
Other
Enumeration date
08/23/2006
Last updated
08/09/2018
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