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General NPI Number Information
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NPI Number | 1720804966
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Entity Type | Organization
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Legal Business Name | CULPEPER FAMILY DENTAL PC
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 1701 SUNSET LN
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City | CULPEPER
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State | VA
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Zip | 22701-3306
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Country | US
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Telephone | 540-825-1366
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Fax |
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Provider Business Mailing Address
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Address Line | 4556 DODDS MILL DR
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City | HAYMARKET
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State | VA
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Zip | 20169-8194
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | IBRAHIM ELGARAWANY
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Credential | DDS
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Telephone | 703-589-7040
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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 |
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License Number State |
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