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General NPI Number Information
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NPI Number | 1871794099
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Entity Type | Individual
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Provider Name | NADIA AMTAL ARMENTROUT D.D.S
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Gender | Female
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 10/08/2015
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Provider Practice Location Address
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Address Line | 100 PURCELLVILLE GATEWAY DR STE D DENTAL SMILES PURCELLVILLE
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City | PURCELLVILLE
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State | VA
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Zip | 20132-3487
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Country | US
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Telephone | 540-338-3330
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Fax |
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Provider Business Mailing Address
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Address Line | 41909 GALLBERRY TER
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City | ALDIE
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State | VA
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Zip | 20105-5664
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Country | US
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Telephone | 413-559-9767
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0401411470
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 016-0002255
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22337
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License Number State | MA
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