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1013059450
OLMEDO IVAN VILLAVICENCIO
ANNANDALE, VA
NPI
1013059450
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: VA 0401007760)
Enumeration Date
2007-02-13
Last Update Date
2007-07-08
Business Address
Dr. OLMEDO IVAN VILLAVICENCIO D.D.S.
7501 LITTLE RIVER TPKE STE 105
ANNANDALE, VA 22003-2923
Phone number: 703-354-2878
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Mailing Address
Dr. OLMEDO IVAN VILLAVICENCIO D.D.S.
7501 LITTLE RIVER TPKE STE 105
ANNANDALE, VA 22003-2923
Phone number: 703-354-2878
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