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315 Garrisonville Rd Suite 105b Stafford VA 22554-1542 | |
| (540) 288-9212 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 315 Garrisonville Rd, Stafford, Virginia |
| Authorized Official Name and Position | Ethel M Miles (PRESIDENT) |
| Authorized Official Contact | 5402889212 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
315 Garrisonville Rd Suite 105b Stafford VA 22554-1542 Ph: (540) 288-9212 | 315 Garrisonville Rd Suite 105b Stafford VA 22554-1542 Ph: (540) 288-9212 |
| NPI Number | 1497052237 |
|---|---|
| Provider Enumeration Date | 02/14/2011 |
| Last Update Date | 02/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497052237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401006823 (Virginia) | Primary |
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