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General NPI Number Information
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NPI Number | 1669669149
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Entity Type | Organization
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Legal Business Name | STEWART C HO DMD PC
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Dates
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Enumeration Date | 09/28/2007
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Last Update Date | 09/28/2007
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Provider Practice Location Address
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Address Line | 3929 OLD LEE HIGHWAY SUITE 91D
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City | FAIRFAX
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State | VA
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Zip | 22030-2421
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Country | US
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Telephone | 703-385-1617
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Fax | 703-865-7711
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Provider Business Mailing Address
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Address Line | 3929 OLD LEE HIGHWAY SUITE 91D
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City | FAIRFAX
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State | VA
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Zip | 22030-2421
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Country | US
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Telephone | 703-385-1617
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Fax | 703-865-7711
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Authorized Official
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Title or Position | PRESIDENT OF PROFESSIONAL CORPORATI
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Name | STEWART CHI CHIU HO
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Credential | DMD
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Telephone | 703-385-1617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401007186
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License Number State | VA
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