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Premier Dental Group Pllc
Pediatric Dentist in Manassas, Virginia
NPI 1063971281

Premier Dental Group Pllc is a Pediatric Dentist based in Manassas, VA and is specialized in Pediatric Dentistry. Premier Dental Group Pllc practices in Manassas, VA. The NPI Number for Premier Dental Group Pllc is 1063971281 and holds a License No. (Virginia).

The current practice location address for Premier Dental Group Pllc is 9420 Forestwood Ln Ste 201, Manassas, VA and can be reached out via phone at 617-943-8812.

Location: 9420 Forestwood Ln Ste 201, Manassas, VA, 20110-4758
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1063971281
Provider Name
Premier Dental Group Pllc
Credential
Provider Entity Type
Organization
Address
9420 Forestwood Ln Ste 201, Manassas, VA, 20110-4758
Phone Number
617-943-8812
Fax Number
Provider Enumeration Date
03/18/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1881968204 05 VA
institution
Provider Business Practice Location Address Details
Address
9420 Forestwood Ln Ste 201
City
Manassas
State
Virginia
Zip
20110-4758
Phone Number
617-943-8812
Fax Number
person
Provider Business Mailing Address Details
Address
9420 Forestwood Ln Ste 201
City
Manassas
State
Virginia
Zip
20110-4758
Phone Number
617-943-8812
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Dentist Anesthesiologist
Taxonomy
1223D0004X
License No.
()
Definition
A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology.
person
Provider's Taxonomy Details 2
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
()
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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