Individual
DR. PAUL FIEBIGER SUPAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
823 SOUTH KING ST, SUITE A, LEESBURG, VA 20175-3920
(703) 771-1220
(703) 771-9333
Mailing address
823 SOUTH KING ST, SUITE A, LEESBURG, VA 20175-3920
(703) 771-1220
(703) 771-9333
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
BS2979411
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28031
UNITED CONCORDIA
—
Enumeration date
10/12/2006
Last updated
07/08/2007
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