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General NPI Number Information
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NPI Number | 1003657826
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Entity Type | Organization
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Legal Business Name | WESLEY S. CREAMER, DMD PLC
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 4565 DAISY REID AVE STE 335
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City | WOODBRIDGE
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State | VA
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Zip | 22192-5671
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Country | US
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Telephone | 703-670-4994
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Fax | 703-730-2187
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Provider Business Mailing Address
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Address Line | 4565 DAISY REID AVE STE 335
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City | WOODBRIDGE
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State | VA
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Zip | 22192-5671
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Country | US
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Telephone | 703-670-4994
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Fax | 703-730-2187
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | WESLEY S CREAMER
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Credential |
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Telephone | 703-670-4994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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