Provider Demographics
NPI:1730926007
Name:GAINESVILLE DENTAL PARTNERS, PC
Entity type:Organization
Organization Name:GAINESVILLE DENTAL PARTNERS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLASANTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-683-6688
Mailing Address - Street 1:14535 JOHN MARSHALL HWY STE 209
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-4025
Mailing Address - Country:US
Mailing Address - Phone:703-753-2252
Mailing Address - Fax:703-832-8618
Practice Address - Street 1:14535 JOHN MARSHALL HWY STE 209
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-4025
Practice Address - Country:US
Practice Address - Phone:703-753-2252
Practice Address - Fax:703-832-8618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty