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General NPI Number Information
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NPI Number | 1497151823
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Entity Type | Organization
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Legal Business Name | WOODLAWN FAMILY DENTISTRY, INC
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Dates
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Enumeration Date | 11/12/2014
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Last Update Date | 11/12/2014
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Provider Practice Location Address
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Address Line | 8492 RICHMOND HWY
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City | ALEXANDRIA
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State | VA
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Zip | 22309-8492
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Country | US
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Telephone | 703-780-3482
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Fax |
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Provider Business Mailing Address
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Address Line | 8492 RICHMOND HWY
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City | ALEXANDRIA
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State | VA
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Zip | 22309-8492
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Country | US
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Telephone | 703-780-3482
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. MONIQUE H NGUYEN
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Credential | DDS
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Telephone | 703-780-3482
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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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