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General NPI Number Information
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NPI Number | 1780023036
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Entity Type | Organization
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Legal Business Name | DRS. DELGADO & KUZMIK, PC
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 06/20/2013
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Provider Practice Location Address
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Address Line | 8230 LEESBURG PIKE SUITE 720
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City | VIENNA
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State | VA
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Zip | 22182-2639
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Country | US
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Telephone | 703-506-1414
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Fax | 703-506-9488
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Provider Business Mailing Address
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Address Line | 8230 LEESBURG PIKE SUITE 720
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City | VIENNA
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State | VA
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Zip | 22182-2639
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Country | US
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Telephone | 703-506-1414
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Fax | 703-506-9488
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD DELGADO
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Credential | D.D.S.
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Telephone | 703-506-1414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 0438000013
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 0438000014
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License Number State | VA
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