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General NPI Number Information
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NPI Number | 1558761551
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Entity Type | Organization
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Legal Business Name | DENTAL DEVOTION PLLC
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Dates
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Enumeration Date | 08/26/2014
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Last Update Date | 04/07/2015
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Provider Practice Location Address
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Address Line | 1005 N GLEBE RD SUITE 460
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City | ARLINGTON
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State | VA
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Zip | 22201-5718
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Country | US
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Telephone | 703-623-5702
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 N GLEBE RD SUITE 460
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City | ARLINGTON
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State | VA
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Zip | 22201-5718
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Country | US
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Telephone | 703-623-5702
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | DR. JAIR P URTEAAGA
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Credential | D.D.S.
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Telephone | 703-623-5702
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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 | 0401412624
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License Number State | VA
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