McLean Oral & Maxillofacial Surgery
McLean Oral & Maxillofacial Surgery is an Exclusive Provider Organization in Mc Lean, Virginia. Licensed in Virginia. Registered with an NPI since 2007.
- Licensed in
- VA
- In the registry since
- 2007
Practice location Address checks out
1515 Chain Bridge Rd Ste 206Mc Lean, VA 22101-4451
Phone: (703) 893-8800
Fax: (703) 893-8845
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Exclusive Provider Organization (primary) | Taxonomy 302F00000X · Licence 3844 (VA) |
|---|
Record details
| NPI number | 1760673214 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Eric Foretich — Owner · (703) 893-8800 |
| NPI enumerated | August 8, 2007 |
| Last updated in NPPES | August 8, 2007 |
| Mailing address | 10440 New Ascot Dr, Great Falls, VA 22066-3421 |