Provider Demographics
NPI:1609532258
Name:DENTACRAFTERS
Entity Type:Organization
Organization Name:DENTACRAFTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:NADA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSADIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-228-6592
Mailing Address - Street 1:101 W BROAD ST STE 510
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4200
Mailing Address - Country:US
Mailing Address - Phone:571-228-6592
Mailing Address - Fax:
Practice Address - Street 1:101 W BROAD ST STE 510
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4200
Practice Address - Country:US
Practice Address - Phone:703-241-5775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty