Provider Demographics
NPI:1063851772
Name:CLAROS DENTAL CARE, PC
Entity Type:Organization
Organization Name:CLAROS DENTAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CLAROS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-272-7350
Mailing Address - Street 1:4231 MARKHAM ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3028
Mailing Address - Country:US
Mailing Address - Phone:703-272-3943
Mailing Address - Fax:703-272-7350
Practice Address - Street 1:4231 MARKHAM ST
Practice Address - Street 2:SUITE 214
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3028
Practice Address - Country:US
Practice Address - Phone:703-272-3943
Practice Address - Fax:703-272-7350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413369122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty