Olmedo Ivan Villavicencio D.D.S.

NPI 1013059450 - Dentist - 1223G0001X

NPI Details
NPI 1013059450
Gender Male
Enumeration Date 02/13/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
7501 LITTLE RIVER TPKE STE 105
ANNANDALE VA, 22003-2923, US
Phone (703) 354-2878
Fax (703) 354-2712
Business Location
7501 LITTLE RIVER TPKE STE 105
ANNANDALE VA, 22003-2923, US
Phone (703) 354-2878
Fax (703) 354-2712
Toxanomy
Taxonomy Code 1223G0001X
License State Virginia
License Number 0401007760
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According to our database, Dr. Olmedo Ivan Villavicencio D.D.S. NPI is 1013059450, taxonomy code is 1223G0001X and license number is 0401007760, license state is located at Virginia. Olmedo Ivan Villavicencio D.D.S. physically located at 7501 Little River Tpke Ste 105, Annandale VA, 22003-2923. NPI Number Olmedo Ivan Villavicencio D.D.S. has the Individual type.

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1013059450 NPI number is provided on an as is basis without warranty of any kind. 1013059450 is maintained by the National Plan & Provider Enumeration System. The contents of Olmedo Ivan Villavicencio D.D.S. are for informational purposes only.