| Gd Va South Riding Pllc | |
|
25055 Riding Plz Ste 250 South Riding VA 20152-5921 | |
| (703) 327-7705 | |
| Not Available |
| Full Name | Gd Va South Riding Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 25055 Riding Plz Ste 250, South Riding, Virginia |
| Authorized Official Name and Position | Chad Hendricks (CREDENTIALING) |
| Authorized Official Contact | 6128590444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gd Va South Riding Pllc 25055 Riding Plz Ste 250 South Riding VA 20152-5921 Ph: (703) 327-7705 | Gd Va South Riding Pllc 25055 Riding Plz Ste 250 South Riding VA 20152-5921 Ph: (703) 327-7705 |
| NPI Number | 1730881590 |
|---|---|
| Provider Enumeration Date | 03/17/2023 |
| Last Update Date | 03/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730881590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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