Light Family Dental-woodbridge | |
14416 Jefferson Davis Hwy Ste 16 Woodbridge VA 22191-2890 | |
(703) 492-1999 | |
Not Available |
Full Name | Light Family Dental-woodbridge |
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Speciality | Dentist |
Location | 14416 Jefferson Davis Hwy Ste 16, Woodbridge, Virginia |
Authorized Official Name and Position | Mayur M Patel (OWNER) |
Authorized Official Contact | 7034921999 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Light Family Dental-woodbridge 14416 Jefferson Davis Hwy Ste 16 Woodbridge VA 22191-2890 Ph: () - | Light Family Dental-woodbridge 14416 Jefferson Davis Hwy Ste 16 Woodbridge VA 22191-2890 Ph: (703) 492-1999 |
NPI Number | 1366787608 |
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Provider Enumeration Date | 11/27/2012 |
Last Update Date | 11/27/2012 |
Identifier | Type | State | Issuer |
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1366787608 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 0401413519 (Virginia) | Primary |
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 0401412959 (Virginia) | Secondary |
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