| Little Bull Run Dental | |
|
13801 Heathcote Blvd Ste 100 Gainesville VA 20155 | |
| (571) 222-6042 | |
| Not Available |
| Full Name | Little Bull Run Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 13801 Heathcote Blvd, Gainesville, Virginia |
| Authorized Official Name and Position | Kendra Walker (CREDENTIALING SUPERVISOR) |
| Authorized Official Contact | 2175408312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Little Bull Run Dental 13801 Heathcote Blvd Ste 100 Gainesville VA 20155 Ph: () - | Little Bull Run Dental 13801 Heathcote Blvd Ste 100 Gainesville VA 20155 Ph: (571) 222-6042 |
| NPI Number | 1346770682 |
|---|---|
| Provider Enumeration Date | 06/19/2017 |
| Last Update Date | 06/19/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346770682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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