Dale P Shewmaker DDS PC
Dentist, General Practice in Fairfax, VA. Organization (NPI-2).
NPI number1356714331
StatusActive
Last updated in NPPESNov 12, 2015
Details
- NPI
- 1356714331
- Entity type
- Organization (NPI-2)
- Legal business name
- Dale P Shewmaker DDS PC
- Organization subpart
- Yes
- Enumeration date
- Nov 12, 2015
- Last updated
- Nov 12, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 0401005882 | VA | Yes |
Practice location
10623 Braddock RdFairfax, VA 22032-2202
Phone 703-385-6960
Mailing address
10623 Braddock RdFairfax, VA 22032-2202
Phone 703-385-6960
Authorized official
Dale P Shewmaker
Dentist/Owner
7033856960
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