Healthcare Provider Details

I. General information

NPI: 1003170309
Provider Name (Legal Business Name): CARL M STEGER DDS & ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 07/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43063 PEACOCK MARKET PLZ STE 125
SOUTH RIDING VA
20152-4478
US

IV. Provider business mailing address

43063 PEACOCK MARKET PLZ STE 125
SOUTH RIDING VA
20152-4478
US

V. Phone/Fax

Practice location:
  • Phone: 703-327-0327
  • Fax: 703-327-3887
Mailing address:
  • Phone: 703-327-0327
  • Fax: 703-327-3887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number0401412248
License Number StateVA

VIII. Authorized Official

Name: CINDY LOAYZA
Title or Position: ADMINISTRATOR
Credential:
Phone: 703-327-0327