NORTHERN VIRGINIA CENTER

FAIRFAX, VA
NPI1639259773
Entity TypeOrganization
Authorized ContactBRENDA LEE PICENTE
Practice Manager
703-449-8888
Organization Subpart ?No
Primary Taxonomy1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: VA  0438000163)
Additional Taxonomies122300000X Dentist
(Licence: VA  0401410440)
Enumeration Date2006-10-16
Last Update Date2011-05-25
Business Address
NORTHERN VIRGINIA CENTER
4211 FAIRFAX CORNER EAST AVE SUITE # 235
FAIRFAX, VA 22030
Phone number: 703-449-8888
Mailing Address
NORTHERN VIRGINIA CENTER
4211 FAIRFAX CORNER EAST AVE SUITE # 235
FAIRFAX, VA 22030
Phone number: 703-449-8888