| Village Oral And Implant Surgery | |
|
1503 Dodona Terrace Sw 105 Leesburg VA 20175 | |
| (855) 373-7688 | |
| Not Available |
| Full Name | Village Oral And Implant Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1503 Dodona Terrace Sw, Leesburg, Virginia |
| Authorized Official Name and Position | Brian Chang (PRESIDENT) |
| Authorized Official Contact | 8553737688 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Village Oral And Implant Surgery 1503 Dodona Terrace Sw 105 Leesburg VA 20175 Ph: (855) 373-7688 | Village Oral And Implant Surgery 1503 Dodona Terrace Sw 105 Leesburg VA 20175 Ph: (855) 373-7688 |
| NPI Number | 1730527110 |
|---|---|
| Provider Enumeration Date | 06/07/2013 |
| Last Update Date | 06/07/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730527110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 0401413779 (Virginia) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 0401413499 (Virginia) | Secondary |
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