Provider Demographics
NPI:1245312677
Name:ANDREW M SKLAR DDS PC
Entity type:Organization
Organization Name:ANDREW M SKLAR DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:MALCOLM
Authorized Official - Last Name:SKLAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-931-3141
Mailing Address - Street 1:4901 SEMINARY RD
Mailing Address - Street 2:#120
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311
Mailing Address - Country:US
Mailing Address - Phone:703-931-3141
Mailing Address - Fax:703-845-1512
Practice Address - Street 1:4901 SEMINARY RD
Practice Address - Street 2:#120
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311
Practice Address - Country:US
Practice Address - Phone:703-931-3141
Practice Address - Fax:703-845-1512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA44881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty