Provider Demographics
NPI:1699845727
Name:PRICE, STEPHEN (DDS)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:PRICE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5417 BACKLICK RD # D
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-3915
Mailing Address - Country:US
Mailing Address - Phone:703-750-9404
Mailing Address - Fax:703-750-9065
Practice Address - Street 1:5417 BACKLICK RD # D
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-3915
Practice Address - Country:US
Practice Address - Phone:703-750-9404
Practice Address - Fax:703-750-9065
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA44741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice