Organization
NIRMAL BOGOLLAGAMA, DDS, PC. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NIRMAL BOGOLLAGAMA DDS (PRESIDENT)
(202) 491-7306
Entity
Organization
Contact information
Practice address
623 GARRISONVILLE RD, STAFFORD, VA 22554-3710
(540) 659-6650
Mailing address
8023 LEWINSVILLE RD, MC LEAN, VA 22102-2435
(202) 491-7306
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401410789
VA
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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