Provider Demographics
NPI:1326395930
Name:DUMFRIES DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:DUMFRIES DENTAL ASSOCIATES
Other - Org Name:HOADLY/PARKWAY DENTAL CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CELMI
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHRAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-221-4535
Mailing Address - Street 1:18043 DUMFRIES SHOPPING PLZ
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-2356
Mailing Address - Country:US
Mailing Address - Phone:703-221-4535
Mailing Address - Fax:703-221-8322
Practice Address - Street 1:18043 DUMFRIES SHOPPING PLZ
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2356
Practice Address - Country:US
Practice Address - Phone:703-221-4535
Practice Address - Fax:703-221-8322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010078181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty