Individual
CARLA STEPHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1625 INTERNATIONAL DR UNIT 120, MC LEAN, VA 22102-4813
(202) 290-0356
Mailing address
1625 INTERNATIONAL DR UNIT 120, MC LEAN, VA 22102-4813
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4804
ZZ
Other
Enumeration date
04/12/2017
Last updated
04/12/2017
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