| Loudoun Endodontics, Pllc | |
|
2 Cardinal Park Dr Se Ste 106a Leesburg VA 20175-4448 | |
| (703) 779-7900 | |
| Not Available |
| Full Name | Loudoun Endodontics, Pllc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 2 Cardinal Park Dr Se Ste 106a, Leesburg, Virginia |
| Authorized Official Name and Position | Matthew Scott Detar (OWNER/ENDODONTIST) |
| Authorized Official Contact | 7033688120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Loudoun Endodontics, Pllc 14426 Beckett Glen Cir Chantilly VA 20151-2140 Ph: (703) 851-6885 | Loudoun Endodontics, Pllc 2 Cardinal Park Dr Se Ste 106a Leesburg VA 20175-4448 Ph: (703) 779-7900 |
| NPI Number | 1588303556 |
|---|---|
| Provider Enumeration Date | 05/30/2022 |
| Last Update Date | 05/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588303556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | (* (Not Available)) | Primary |
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