| Prince William Dental Llc | |
|
7051 Heathcote Village Way Ste 100 Gainesville VA 20155-3197 | |
| (848) 667-0516 | |
| Not Available |
| Full Name | Prince William Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 7051 Heathcote Village Way Ste 100, Gainesville, Virginia |
| Authorized Official Name and Position | Madhusudhan Reddy Kasipathy (DENTIST/ OWNER) |
| Authorized Official Contact | 8486670516 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prince William Dental Llc 43313 Barnstead Dr Ashburn VA 20148-6890 Ph: (848) 667-0516 | Prince William Dental Llc 7051 Heathcote Village Way Ste 100 Gainesville VA 20155-3197 Ph: (848) 667-0516 |
| NPI Number | 1609499151 |
|---|---|
| Provider Enumeration Date | 05/19/2020 |
| Last Update Date | 05/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609499151 | NPI | - | NPPES |
| 1316100639 | Other | VA | MADHUSUDHAN KASIPATHY |
| 1750583738 | Other | VA | KOWSHIK VADDI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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