Provider Demographics
NPI:1730465212
Name:OUTTEN, WILLIAM LINWOOD III (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LINWOOD
Last Name:OUTTEN
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10721 MAIN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6902
Mailing Address - Country:US
Mailing Address - Phone:703-273-5900
Mailing Address - Fax:703-273-8232
Practice Address - Street 1:10721 MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6902
Practice Address - Country:US
Practice Address - Phone:703-273-5900
Practice Address - Fax:703-273-8232
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA04010030281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice