Healthcare Provider Details

I. General information

NPI: 1306275110
Provider Name (Legal Business Name): CAROLINE CORRIGAN ESKOW D.D.S, M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2013
Last Update Date: 11/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10550 WARWICK AVE
FAIRFAX VA
22030-3133
US

IV. Provider business mailing address

10550 WARWICK AVE
FAIRFAX VA
22030-3133
US

V. Phone/Fax

Practice location:
  • Phone: 703-273-7846
  • Fax:
Mailing address:
  • Phone: 703-273-7846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number0401413972
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number15327
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDEN1001257
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: