Keith J Wilson DDS PC
Keith J Wilson DDS PC is a General Practice Dentistry in Fairfax, Virginia. Licensed in Virginia. Registered with an NPI since 2007.
- Licensed in
- VA
- In the registry since
- 2007
What do these letters mean?
- PC — Professional corporation
- A form of business registration, not a clinical qualification.
Practice location Address checks out
11166 Fairfax Blvd Ste 400Fairfax, VA 22030-5017
Phone: (703) 691-3015
Fax: (703) 691-3016
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X · Licence 0401008681 (VA) |
|---|
Record details
| NPI number | 1154447589 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Keith Wilson — Owner President · (703) 691-3015 |
| Other names | Fair Lakes Dental Services |
| NPI enumerated | March 21, 2007 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 11166 Fairfax Blvd Ste 400, Fairfax, VA 22030-5017 |
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Dr. Daniel P. Kelliher, DDS
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Robert Christian Kertscher, DDSPC
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Dr. Laura Yoomee Ki, DDS
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