Fairfax Ent & Facial Plastic Surgery, Pc

NPI 1720259054 - Otolaryngology - 207YX0007X

NPI Details
NPI 1720259054
Enumeration Date 03/14/2008
Last Updated 06/15/2016
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name LAURENCE R LAURENCE
Position PRESIDENT
Phone (703) 573-3687
Fax (703) 204-0114
Practice Location
8120 GATEHOUSE RD
#3
FALLS CHURCH VA, 22042-1204, US
Phone (703) 573-3687
Fax (703) 204-0114
Business Location
8120 GATEHOUSE RD
#3
FALLS CHURCH VA, 22042-1204, US
Phone (703) 573-3687
Fax (703) 698-1334
Toxanomy
Taxonomy Code 207YX0007X
License State Virginia
License Number 0101051134
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According to our database, Fairfax Ent & Facial Plastic Surgery, Pc NPI is 1720259054, taxonomy code is 207YX0007X and license number is 0101051134, license state is located at Virginia. Fairfax Ent & Facial Plastic Surgery, Pc physically located at 8120 Gatehouse Rd, Falls Church VA, 22042-1204. NPI Number 1033115704 has the healthcare provider type.

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1720259054 NPI number is provided on an as is basis without warranty of any kind. 1720259054 is maintained by the National Plan & Provider Enumeration System. The contents of Fairfax Ent & Facial Plastic Surgery, Pc are for informational purposes only.