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General NPI Number Information
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NPI Number | 1720230865
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Entity Type | Organization
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Legal Business Name | VERONICA M. ENRIQUEZ, DDS, INC.
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 10/22/2009
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Provider Practice Location Address
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Address Line | 14102 SULLYFIELD CIR SUITE 500
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City | CHANTILLY
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State | VA
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Zip | 20151-1610
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Country | US
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Telephone | 703-378-4004
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Fax |
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Provider Business Mailing Address
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Address Line | 14102 SULLYFIELD CIR SUITE 500
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City | CHANTILLY
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State | VA
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Zip | 20151-1610
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Country | US
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Telephone | 703-378-4004
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. VERONICA M ENRIQUEZ
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Credential | D.D.S.
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Telephone | 703-378-4004
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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 | 0401008941
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License Number State | VA
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