Provider Demographics
NPI:1437308590
Name:DUCHATELLIER-CANGE, RUTH KATHLEEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:KATHLEEN
Last Name:DUCHATELLIER-CANGE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22621 AMENDOLA TER
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-7528
Mailing Address - Country:US
Mailing Address - Phone:703-723-0400
Mailing Address - Fax:703-723-0403
Practice Address - Street 1:22621 AMENDOLA TER
Practice Address - Street 2:SUITE 110
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20148-7528
Practice Address - Country:US
Practice Address - Phone:703-723-0400
Practice Address - Fax:703-723-0403
Is Sole Proprietor?:No
Enumeration Date:2008-09-13
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10008581223G0001X
VA04014126221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice