| Premium Family Dental Pc | |
|
6328 Richmond Hwy Ste F Alexandria VA 22306-6408 | |
| (703) 606-8458 | |
| Not Available |
| Full Name | Premium Family Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 6328 Richmond Hwy Ste F, Alexandria, Virginia |
| Authorized Official Name and Position | Vu Nguyen (PRESIDENT) |
| Authorized Official Contact | 7036068458 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premium Family Dental Pc 3618 Highland Pl Fairfax VA 22033-2718 Ph: () - | Premium Family Dental Pc 6328 Richmond Hwy Ste F Alexandria VA 22306-6408 Ph: (703) 606-8458 |
| NPI Number | 1063718104 |
|---|---|
| Provider Enumeration Date | 02/08/2011 |
| Last Update Date | 02/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063718104 | NPI | - | NPPES |
| 010141605 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 0401410920 (Virginia) | Primary |
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