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General NPI Number Information
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NPI Number | 1689875536
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Entity Type | Organization
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Legal Business Name | JEREMIAH N. PARTRICK, JR. DDS PC
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3801 FAIRFAX DR SUITE 65
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City | ARLINGTON
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State | VA
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Zip | 22203-1762
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Country | US
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Telephone | 703-522-6111
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Fax | 703-525-2900
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Provider Business Mailing Address
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Address Line | 3801 FAIRFAX DR SUITE 65
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City | ARLINGTON
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State | VA
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Zip | 22203-1762
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Country | US
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Telephone | 703-522-6111
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Fax | 703-525-2900
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JEREMIAH N. PARTRICK, JR
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Credential | DDS
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Telephone | 703-522-6111
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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 | 0401008738
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License Number State | VA
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