Provider Demographics
NPI:1669802591
Name:J CHRISTOPHER DURR LLC
Entity type:Organization
Organization Name:J CHRISTOPHER DURR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER AND MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:DURR
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS JD
Authorized Official - Phone:703-941-7020
Mailing Address - Street 1:4216 EVERGREEN LN
Mailing Address - Street 2:SUITE 113
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3243
Mailing Address - Country:US
Mailing Address - Phone:703-941-7020
Mailing Address - Fax:
Practice Address - Street 1:4216 EVERGREEN LN
Practice Address - Street 2:SUITE 113
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3243
Practice Address - Country:US
Practice Address - Phone:703-941-7020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA5391261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental