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General NPI Number Information
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NPI Number | 1568618429
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Entity Type | Organization
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Legal Business Name | ACKERMAN AND ASSOCIATES OF GREAT FALLS
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Dates
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Enumeration Date | 08/12/2008
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 774 WALKER RD STE B
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City | GREAT FALLS
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State | VA
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Zip | 22066-2648
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Country | US
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Telephone | 703-759-4707
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Fax | 703-759-4721
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Provider Business Mailing Address
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Address Line | 774 WALKER RD STE B
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City | GREAT FALLS
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State | VA
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Zip | 22066-2648
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Country | US
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Telephone | 703-759-4707
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Fax | 703-759-4721
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY S ACKERMAN
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Credential | D.D.S.
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Telephone | 703-759-4707
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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 | 0401004044
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License Number State | VA
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