Healthcare Provider Details

I. General information

NPI: 1275716581
Provider Name (Legal Business Name): J. DANIEL LABRIOLA DDS AND DAVID J CANTOR DMD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7611 LITTLE RIVER TPKE SUITE 101-E
ANNANDALE VA
22003-2611
US

IV. Provider business mailing address

7611 LITTLE RIVER TPKE SUITE 101-E
ANNANDALE VA
22003-2611
US

V. Phone/Fax

Practice location:
  • Phone: 703-256-2307
  • Fax: 703-256-3230
Mailing address:
  • Phone: 703-256-2307
  • Fax: 703-256-3230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number StateVA

VIII. Authorized Official

Name: DR. J. DANIEL LABRIOLA
Title or Position: PARTNER
Credential: DDS
Phone: 703-256-2307