Healthcare Provider Details

I. General information

NPI: 1215017306
Provider Name (Legal Business Name): BRIAN L. CARINO D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

381 STUYVESANT ST STE 3
WARRENTON VA
20186-2400
US

IV. Provider business mailing address

381 STUYVESANT ST STE 3
WARRENTON VA
20186-2400
US

V. Phone/Fax

Practice location:
  • Phone: 540-347-2233
  • Fax: 540-341-4700
Mailing address:
  • Phone: 540-347-2233
  • Fax: 540-341-4700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10913
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: