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General NPI Number Information
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NPI Number | 1629573423
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Entity Type | Organization
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Legal Business Name | PAUL JIRAL DDS & ASSOCIATES PC
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 03/26/2018
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Provider Practice Location Address
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Address Line | 560 CELEBRATE VIRGINIA PKWY STE 107
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City | FREDERICKSBURG
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State | VA
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Zip | 22406-7298
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Country | US
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Telephone | 540-286-1110
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Fax |
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Provider Business Mailing Address
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Address Line | 560 CELEBRATE VIRGINIA PKWY STE 107
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City | FREDERICKSBURG
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State | VA
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Zip | 22406-7298
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Country | US
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Telephone | 540-286-1110
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. CELIA JIRAL
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Credential |
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Telephone | 540-286-1110
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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 | 0401007285
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License Number State | VA
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