|
| |
|
9010 Lorton Station Blvd. Suite 150 Lorton VA 22079 | |
| (703) 339-5690 | |
| (703) 339-5692 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9010 Lorton Station Blvd., Lorton, Virginia |
| Authorized Official Name and Position | Eugenia A Walsh (PRESIDENT) |
| Authorized Official Contact | 2025509444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9010 Lorton Station Blvd. Suite 150 Lorton VA 22079 Ph: (703) 339-5690 | 9010 Lorton Station Blvd. Suite 150 Lorton VA 22079 Ph: (703) 339-5690 |
| NPI Number | 1720211501 |
|---|---|
| Provider Enumeration Date | 08/27/2009 |
| Last Update Date | 10/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720211501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401412109 (Virginia) | Primary |
Gentle Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9360 Richmond Hwy, Lorton, VA 22079 Phone: 703-495-9992 Fax: 703-495-9993 | |
United Dental Sleep Medicine, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9020 Lorton Station Blvd Unit F104, Lorton, VA 22079 Phone: 804-625-4066 Fax: 804-414-7491 | |