NPI 1447433578

Team Dental at River Oaks

Organisation Exclusive Provider Organization Woodbridge, VA

Practice location

Address: 16689 River Ridge Blvd, Woodbridge, VA 22191-4630
Phone: (703) 221-9759
Fax: (703) 221-2782

Authorised official

Name: Michael Enon King
Title: Dentist
Phone: (703) 221-9759

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 8593 (VA)

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Registry record

NPI: 1447433578
Entity type: Organization
NPI issued: 12 Dec 2007
Record last updated: 12 Dec 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.