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General NPI Number Information
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NPI Number | 1093295149
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Entity Type | Organization
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Legal Business Name | LUX DENTAL CENTER
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Dates
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Enumeration Date | 08/17/2018
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 43761 PARKHURST PLZ STE 132
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City | ASHBURN
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State | VA
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Zip | 20147-5470
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Country | US
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Telephone | 571-485-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 43761 PARKHURST PLZ STE 132
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City | ASHBURN
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State | VA
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Zip | 20147-5470
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Country | US
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Telephone | 571-485-2900
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | LYNN ALEXANDER
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Credential |
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Telephone | 571-485-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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