| South Fork Dentistry Pllc | |
|
723 E Main St Purcellville VA 20132 | |
| (571) 335-7480 | |
| Not Available |
| Full Name | South Fork Dentistry Pllc |
|---|---|
| Speciality | Dentist |
| Location | 723 E Main St, Purcellville, Virginia |
| Authorized Official Name and Position | Simren Mahal (OWNER) |
| Authorized Official Contact | 5713357480 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Fork Dentistry Pllc 19783 Willowdale Pl Ashburn VA 20147-5209 Ph: (703) 297-6793 | South Fork Dentistry Pllc 723 E Main St Purcellville VA 20132 Ph: (571) 335-7480 |
| NPI Number | 1265190417 |
|---|---|
| Provider Enumeration Date | 12/06/2021 |
| Last Update Date | 12/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265190417 | NPI | - | NPPES |
| 1922408160 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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