Provider Demographics
NPI:1225124662
Name:PARTRICK, JEREMIAH NOLAN JR (DDS)
Entity Type:Individual
Prefix:MR
First Name:JEREMIAH
Middle Name:NOLAN
Last Name:PARTRICK
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:3801 N FAIRFAX DR
Mailing Address - Street 2:SUITE 65
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203
Mailing Address - Country:US
Mailing Address - Phone:703-522-6111
Mailing Address - Fax:703-525-2900
Practice Address - Street 1:3801 N FAIRFAX DR
Practice Address - Street 2:SUITE 65
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203
Practice Address - Country:US
Practice Address - Phone:703-522-6111
Practice Address - Fax:703-525-2900
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0401008738122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist