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General NPI Number Information
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NPI Number | 1073236592
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Entity Type | Organization
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Legal Business Name | FAMILY FIRST DENTAL PC
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 4425 PLANK RD STE B
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-4809
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Country | US
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Telephone | 540-786-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 4425 PLANK RD STE B
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-4809
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Country | US
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Telephone | 540-786-1212
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Fax |
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Authorized Official
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Title or Position | COO
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Name | HAJA WILLIAMS
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Credential |
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Telephone | 540-786-1212
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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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