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General NPI Number Information
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NPI Number | 1720588973
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Entity Type | Organization
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Legal Business Name | STEPHEN A MABRY DDS PLC
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Dates
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Enumeration Date | 02/14/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 2800 10TH ST N
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City | ARLINGTON
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State | VA
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Zip | 22201-2174
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Country | US
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Telephone | 703-527-3554
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Fax | 703-527-8762
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Provider Business Mailing Address
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Address Line | 2800 10TH ST N
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City | ARLINGTON
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State | VA
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Zip | 22201-2174
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Country | US
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Telephone | 703-527-3554
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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 | BETH BRADY
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Credential |
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Telephone | 703-527-3554
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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 | 0401411464
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License Number State | VA
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