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General NPI Number Information
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NPI Number | 1215560370
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Entity Type | Organization
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Legal Business Name | RED APPLE PEDIATRIC DENTAL TEAM
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Dates
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Enumeration Date | 02/18/2020
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 1003 GARRISONVILLE RD
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City | STAFFORD
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State | VA
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Zip | 22556-1843
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Country | US
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Telephone | 540-318-5577
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Fax | 540-369-6250
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Provider Business Mailing Address
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Address Line | 1003 GARRISONVILLE RD
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City | STAFFORD
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State | VA
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Zip | 22556-1843
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Country | US
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Telephone | 540-318-5577
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Fax | 540-369-6250
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Authorized Official
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Title or Position | FRONT DESK
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Name | SKYLAR ASHBY
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Credential |
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Telephone | 540-318-5577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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