MEDICARE: CAITLIN SPURLOCK HULVER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	4060	WV
2	1223G0001X	General Practice Dentistry	0401415121	VA

General Provider Information

NPI Number	:	1053759027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLIN SPURLOCK HULVER DDS

Provider Business Mailing Address
First Line	:	10509 BRADDOCK RD STE B
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22032-2239
Country	:	US
Telephone Number	:	35-035-0317
Fax Number	:

Provider Business Practice Location Address
First Line	:	10509 BRADDOCK RD STE B
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22032-2239
Country	:	US
Telephone Number	:	703-503-5031
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2013
Last Update Date	:	01/07/2020

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Directions to “ CAITLIN SPURLOCK HULVER DDS” Practice Location

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