| Dale P Shewmaker DDS PC | |
|
10623 Braddock Rd Fairfax VA 22032-2202 | |
| (703) 385-6960 | |
| Not Available |
| Full Name | Dale P Shewmaker DDS PC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10623 Braddock Rd, Fairfax, Virginia |
| Authorized Official Name and Position | Dale P Shewmaker (DENTIST/OWNER) |
| Authorized Official Contact | 7033856960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dale P Shewmaker DDS PC 10623 Braddock Rd Fairfax VA 22032-2202 Ph: (703) 385-6960 | Dale P Shewmaker DDS PC 10623 Braddock Rd Fairfax VA 22032-2202 Ph: (703) 385-6960 |
| NPI Number | 1356714331 |
|---|---|
| Provider Enumeration Date | 11/12/2015 |
| Last Update Date | 11/12/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356714331 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401005882 (Virginia) | Primary |
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