| Tjb Of Dulles, Llc | |
|
24565 Dulles Landing Dr Suite 190 Dulles VA 20166-2612 | |
| (703) 468-0188 | |
| (703) 754-1694 |
| Full Name | Tjb Of Dulles, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 24565 Dulles Landing Dr, Dulles, Virginia |
| Authorized Official Name and Position | Kerri Nichols (REGIONAL DIRECTOR) |
| Authorized Official Contact | 5404948776 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tjb Of Dulles, Llc 24565 Dulles Landing Dr Suite 190 Dulles VA 20166-2612 Ph: (703) 542-7300 | Tjb Of Dulles, Llc 24565 Dulles Landing Dr Suite 190 Dulles VA 20166-2612 Ph: (703) 468-0188 |
| NPI Number | 1457720302 |
|---|---|
| Provider Enumeration Date | 09/22/2015 |
| Last Update Date | 09/22/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457720302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 0401410720 (Virginia) | Secondary |
| 261QD0000X | Clinic/center - Dental | 0401007652 (Virginia) | Primary |
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