Provider Demographics
NPI:1205344546
Name:DENTAL FIRST ASSOCIATES
Entity type:Organization
Organization Name:DENTAL FIRST ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-323-9394
Mailing Address - Street 1:6116 ROLLING RD STE 312
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-1512
Mailing Address - Country:US
Mailing Address - Phone:703-323-9394
Mailing Address - Fax:
Practice Address - Street 1:6116 ROLLING RD STE 312
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1512
Practice Address - Country:US
Practice Address - Phone:703-323-9394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental