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General NPI Number Information
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NPI Number | 1497120174
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Entity Type | Organization
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Legal Business Name | VIP DENTAL
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Dates
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Enumeration Date | 12/07/2015
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Last Update Date | 12/07/2015
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Provider Practice Location Address
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Address Line | 20915 ASHBURN RD STE 245
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City | ASHBURN
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State | VA
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Zip | 20147-5679
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Country | US
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Telephone | 571-276-3759
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Fax |
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Provider Business Mailing Address
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Address Line | 20915 ASHBURN RD STE 245
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City | ASHBURN
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State | VA
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Zip | 20147-5679
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DUY-ANH DUC VU
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Credential | DDS
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Telephone | 571-276-3759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 0401413312
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License Number State | VA
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