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General NPI Number Information
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NPI Number | 1881344968
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Entity Type | Organization
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Legal Business Name | QUANTICO DENTAL CARE PLLC
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | 16830 DUMFRIES RD
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City | DUMFRIES
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State | VA
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Zip | 22025
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Country | US
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Telephone | 703-380-1246
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Fax |
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Provider Business Mailing Address
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Address Line | 13308 REGAL CREST DR
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City | CLIFTON
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State | VA
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Zip | 20124-0979
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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 | DENTIST
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Name | PALWINDER KAUR
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Credential |
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Telephone | 703-952-6600
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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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