| Famidental | |
|
9554 Old Keene Mill Rd Ste C Burke VA 22015-4287 | |
| (703) 952-4003 | |
| (571) 281-0001 |
| Full Name | Famidental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9554 Old Keene Mill Rd Ste C, Burke, Virginia |
| Authorized Official Name and Position | Waldo Valdivia (DENTIST) |
| Authorized Official Contact | 7039524003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Famidental 9554 Old Keene Mill Rd Ste C Burke VA 22015-4287 Ph: (703) 952-4003 | Famidental 9554 Old Keene Mill Rd Ste C Burke VA 22015-4287 Ph: (703) 952-4003 |
| NPI Number | 1306628482 |
|---|---|
| Provider Enumeration Date | 10/16/2023 |
| Last Update Date | 10/16/2023 |
| Certification Date | 10/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306628482 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (NU) | Primary |
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