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General NPI Number Information
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NPI Number | 1740622406
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Entity Type | Organization
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Legal Business Name | ROBERT C DOST DDS PLLC
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Dates
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Enumeration Date | 07/23/2013
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 1990 OLD BRIDGE RD SUITE #301
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City | LAKE RIDGE
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State | VA
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Zip | 22192-2383
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Country | US
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Telephone | 703-491-4040
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Fax | 703-494-4859
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Provider Business Mailing Address
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Address Line | 1990 OLD BRIDGE RD SUITE #301
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City | LAKE RIDGE
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State | VA
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Zip | 22192-2383
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Country | US
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Telephone | 703-491-4040
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Fax | 703-494-4859
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. BRENDA LEE CREEL
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Credential |
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Telephone | 703-491-4040
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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 | 40100-5831
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License Number State | VA
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