Provider Demographics
NPI:1780023036
Name:DRS. DELGADO & KUZMIK, PC
Entity Type:Organization
Organization Name:DRS. DELGADO & KUZMIK, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-506-1414
Mailing Address - Street 1:8230 LEESBURG PIKE
Mailing Address - Street 2:SUITE 720
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2639
Mailing Address - Country:US
Mailing Address - Phone:703-506-1414
Mailing Address - Fax:703-506-9488
Practice Address - Street 1:8230 LEESBURG PIKE
Practice Address - Street 2:SUITE 720
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2639
Practice Address - Country:US
Practice Address - Phone:703-506-1414
Practice Address - Fax:703-506-9488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04380000141223S0112X
VA04380000131223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty