| King Centre Dental | |
|
5695 King Centre Dr Ste. B-100 Alexandria VA 22315-5744 | |
| (703) 719-9824 | |
| Not Available |
| Full Name | King Centre Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5695 King Centre Dr, Alexandria, Virginia |
| Authorized Official Name and Position | Cleophus Benson Clark (DENTIST OWNER) |
| Authorized Official Contact | 7037199824 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| King Centre Dental 5695 King Centre Dr Ste. B-100 Alexandria VA 22315-5744 Ph: (703) 719-9824 | King Centre Dental 5695 King Centre Dr Ste. B-100 Alexandria VA 22315-5744 Ph: (703) 719-9824 |
| NPI Number | 1134503444 |
|---|---|
| Provider Enumeration Date | 07/16/2015 |
| Last Update Date | 09/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134503444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401003822 (Virginia) | Primary |
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