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General NPI Number Information
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NPI Number | 1417898743
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Entity Type | Organization
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Legal Business Name | NAMU DENTAL STAFFORD PLLC
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 400 CORPORATE DR STE 200
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City | STAFFORD
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State | VA
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Zip | 22554-4898
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Country | US
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Telephone | 540-288-9212
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Fax |
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Provider Business Mailing Address
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Address Line | 400 CORPORATE DR STE 200
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City | STAFFORD
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State | VA
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Zip | 22554-4898
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Country | US
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Telephone | 540-288-9212
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ERICA COOK
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Credential |
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Telephone | 281-723-1175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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