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1265190417
SOUTH FORK DENTISTRY PLLC
PURCELLVILLE, VA
NPI
1265190417
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Entity Type
Organization
Authorized Contact
SIMREN MAHAL
Owner
571-335-7480
Organization Subpart ?
No
Primary Taxonomy
122300000X Dentist
Enumeration Date
2021-12-06
Last Update Date
2021-12-06
Business Address
SOUTH FORK DENTISTRY PLLC
723 E MAIN ST
PURCELLVILLE, VA 20132
Phone number: 571-335-7480
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Mailing Address
SOUTH FORK DENTISTRY PLLC
19783 WILLOWDALE PL
ASHBURN, VA 20147-5209
Phone number: 703-297-6793
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