Provider Demographics
NPI:1497151823
Name:WOODLAWN FAMILY DENTISTRY, INC
Entity Type:Organization
Organization Name:WOODLAWN FAMILY DENTISTRY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:H
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-780-3482
Mailing Address - Street 1:8492 RICHMOND HWY
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-8492
Mailing Address - Country:US
Mailing Address - Phone:703-780-3482
Mailing Address - Fax:
Practice Address - Street 1:8492 RICHMOND HWY
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309-8492
Practice Address - Country:US
Practice Address - Phone:703-780-3482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOODLAWN FAMILY DENTISTRY,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-12
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty