Organization · Type 2 NPI

Dedicated Dental PLLC

Dental Clinic/Center · Stafford, VA

NPI number 1700469103 Active

Practice location

11 Hope Rd Ste 201
Stafford, VA 22554-7287

Specialties and licenses

Taxonomy	Code	License
Dental Clinic/Center Primary	261QD0000X	None listed

Dental Clinic/Center: Definition to come...

2 other providers at this address

Other dental clinic/center providers in Stafford

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NPI record

NPI: 1700469103
Entity type: Organization (Type 2)
Issued: May 3, 2021
Last updated: May 3, 2021
Status: Active

Other names

Dedicated Dental · doing business as
Dedicated Dental LLC · former legal business name

Authorized official

Dr. Carter M Waller, DMD
Part Owner Dentist
(561) 901-4700

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About NPI 1700469103

Dedicated Dental PLLC's National Provider Identifier is 1700469103, issued on May 3, 2021. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Stafford, VA. The record was last updated on May 3, 2021.