| Loudoun Pediatric Dentistry | |
|
1503 Dodona Ter Ste 200 Leesburg VA 20175-4718 | |
| (703) 771-0007 | |
| (703) 771-6088 |
| Full Name | Loudoun Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1503 Dodona Ter Ste 200, Leesburg, Virginia |
| Authorized Official Name and Position | Steve J Lan (PRESIDENT) |
| Authorized Official Contact | 7037710007 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Loudoun Pediatric Dentistry 1503 Dodona Ter Ste 200 Leesburg VA 20175-4718 Ph: (703) 771-0007 | Loudoun Pediatric Dentistry 1503 Dodona Ter Ste 200 Leesburg VA 20175-4718 Ph: (703) 771-0007 |
| NPI Number | 1174821003 |
|---|---|
| Provider Enumeration Date | 03/01/2011 |
| Last Update Date | 08/07/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174821003 | NPI | - | NPPES |
| 035518600 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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