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General NPI Number Information
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NPI Number | 1578203824
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Entity Type | Organization
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Legal Business Name | PETER SON, DDS PC
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Dates
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Enumeration Date | 04/01/2022
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Last Update Date | 04/01/2022
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Provider Practice Location Address
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Address Line | 10623 BRADDOCK RD
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City | FAIRFAX
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State | VA
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Zip | 22032-2202
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Country | US
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Telephone | 703-385-6960
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Fax |
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Provider Business Mailing Address
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Address Line | 10623 BRADDOCK RD
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City | FAIRFAX
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State | VA
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Zip | 22032-2202
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Country | US
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Telephone | 703-385-6960
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PETER SON
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Credential | DDS
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Telephone | 571-528-7570
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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 |
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License Number State |
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