| Priya Gupta DDS PC | |
|
4001 Legato Rd Ste 203 Fairfax VA 22033-4098 | |
| (703) 385-7177 | |
| Not Available |
| Full Name | Priya Gupta DDS PC |
|---|---|
| Speciality | Dentist |
| Location | 4001 Legato Rd Ste 203, Fairfax, Virginia |
| Authorized Official Name and Position | Priya Gupta (PRESIDENT/OWNER) |
| Authorized Official Contact | 7036094144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Priya Gupta DDS PC 12380 Clareth Dr Herndon VA 20171-2015 Ph: (703) 609-4144 | Priya Gupta DDS PC 4001 Legato Rd Ste 203 Fairfax VA 22033-4098 Ph: (703) 385-7177 |
| NPI Number | 1780391425 |
|---|---|
| Provider Enumeration Date | 11/02/2022 |
| Last Update Date | 12/06/2023 |
| Certification Date | 12/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780391425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Primary |
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