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General NPI Number Information
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NPI Number | 1598983314
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Entity Type | Organization
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Legal Business Name | RBH DENTAL MGT. GROUP, INC
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9612 MINSTEAD CT
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City | BURKE
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State | VA
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Zip | 22015-4056
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Country | US
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Telephone | 202-468-7383
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Fax | 703-455-5766
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Provider Business Mailing Address
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Address Line | 9612 MINSTEAD CT
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City | BURKE
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State | VA
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Zip | 22015-4056
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Country | US
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Telephone |
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Fax | 703-455-5766
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JENNIFER HILARIO DIAZ
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Credential | DDS
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Telephone | 703-455-5766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 0401411082
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License Number State | VA
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