| Addax Dental Pllc | |
|
546 E Market St Leesburg VA 20176-4112 | |
| (703) 777-5939 | |
| Not Available |
| Full Name | Addax Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 546 E Market St, Leesburg, Virginia |
| Authorized Official Name and Position | Michael Doe (MANAGING CLINICAL DIRECTOR) |
| Authorized Official Contact | 7037775939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Addax Dental Pllc 546 E Market St Leesburg VA 20176-4112 Ph: (703) 777-5939 | Addax Dental Pllc 546 E Market St Leesburg VA 20176-4112 Ph: (703) 777-5939 |
| NPI Number | 1154692408 |
|---|---|
| Provider Enumeration Date | 01/18/2012 |
| Last Update Date | 01/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154692408 | NPI | - | NPPES |
| 110088059A | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401413091 (Virginia) | Primary |
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