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General NPI Number Information
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NPI Number | 1750998878
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Entity Type | Organization
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Legal Business Name | NADGIE ORTIZ DIAZ DMD PLLC
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Dates
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Enumeration Date | 09/24/2020
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Last Update Date | 09/24/2020
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Provider Practice Location Address
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Address Line | 24560 SOUTHPOINT DR STE 240
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City | ALDIE
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State | VA
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Zip | 20105-3505
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Country | US
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Telephone | 276-663-3126
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Fax | 276-663-3121
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Provider Business Mailing Address
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Address Line | 24560 SOUTHPOINT DR STE 240
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City | ALDIE
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State | VA
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Zip | 20105-3505
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Country | US
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Telephone | 276-663-3126
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Fax | 276-663-3121
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Authorized Official
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Title or Position | PEDIATRIC DENTIST OWNER
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Name | NADGIE ORTIZ DIAZ
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Credential | DMD
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Telephone | 276-663-3126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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