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NPI Code Detail

MEDICARE: EXQUISITE DENTAL CARE

MEDICARE: EXQUISITE DENTAL CARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry0401412525VA
21223G0001XGeneral Practice Dentistry0401411050VA

General Provider Information

NPI Number : 1568797413
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXQUISITE DENTAL CARE
Provider Business Mailing Address
First Line : 300 N WASHINGTON ST STE 210
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-2530
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 N WASHINGTON ST STE 210
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-2530
Country : US
Telephone Number : 202-659-3500
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. DONNA REID
Credential :
Telephone Number : 202-659-3500
Provider Enumeration Date : 10/10/2009
Last Update Date : 10/10/2009

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Directions to “EXQUISITE DENTAL CARE ” Practice Location

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