Provider Demographics
NPI:1164591970
Name:VIGLIANTE, CRAIG ERNEST (MD DMD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ERNEST
Last Name:VIGLIANTE
Suffix:
Gender:M
Credentials:MD DMD
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Mailing Address - Street 1:19440 GOLF VISTA PLAZA
Mailing Address - Street 2:STE 130
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176
Mailing Address - Country:US
Mailing Address - Phone:703-723-5366
Mailing Address - Fax:703-723-5537
Practice Address - Street 1:19440 GOLF VISTA PLAZA
Practice Address - Street 2:STE 130
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176
Practice Address - Country:US
Practice Address - Phone:703-723-5366
Practice Address - Fax:703-723-5537
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0401410769204E00000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Not Answered208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery