Individual
DR. MICHAEL CHARLES MOCKNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
6845 ELM ST, SUITE 509, MC LEAN, VA 22101-6007
(703) 734-0334
Mailing address
6845 ELM ST, SUITE 509, MC LEAN, VA 22101-6007
(703) 734-0334
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401008063
VA
1223E0200X
Endodontics
9122
MD
Other
Enumeration date
05/17/2008
Last updated
05/17/2008
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