Provider Demographics
NPI:1992952600
Name:JASON S WOODSIDE DDS & THOMAS C SENTZ DDS, P.C.
Entity type:Organization
Organization Name:JASON S WOODSIDE DDS & THOMAS C SENTZ DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:S
Authorized Official - Last Name:WOODSIDE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-341-4111
Mailing Address - Street 1:361 WALKER DR.
Mailing Address - Street 2:#204
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186
Mailing Address - Country:US
Mailing Address - Phone:540-341-4111
Mailing Address - Fax:540-341-4991
Practice Address - Street 1:361 WALKER DR.
Practice Address - Street 2:#204
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186
Practice Address - Country:US
Practice Address - Phone:540-341-4111
Practice Address - Fax:540-341-4991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014104011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty