Provider Demographics
NPI:1720095573
Name:CALLAHAN DENTAL
Entity Type:Organization
Organization Name:CALLAHAN DENTAL
Other - Org Name:PAUL W. CALLAHAN, D.D.S. & KAREN M. CALLAHAN, D.D.S.,P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:W
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-444-4104
Mailing Address - Street 1:14 PIDGEON HILL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-6155
Mailing Address - Country:US
Mailing Address - Phone:703-444-4104
Mailing Address - Fax:703-444-9344
Practice Address - Street 1:14 PIDGEON HILL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6155
Practice Address - Country:US
Practice Address - Phone:703-444-4104
Practice Address - Fax:703-444-9344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401006996122300000X
VA0401007004122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty