Organization
PREMIER DENTAL ARTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAN YU DMD (DENTIST /OWNER)
(703) 865-6276
Entity
Organization
Contact information
Practice address
4001 FAIR RIDGE DR STE 105, FAIRFAX, VA 22033-2917
(703) 865-6276
(888) 492-5156
Mailing address
4001 FAIR RIDGE DR STE 105, FAIRFAX, VA 22033-2917
(703) 865-6276
(888) 492-5156
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
0401413342
VA
Other
Enumeration date
05/28/2014
Last updated
05/28/2014
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