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8715 Stonewall Road Manassas VA 20110 | |
| (703) 361-4278 | |
| (703) 361-2449 |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 8715 Stonewall Road, Manassas, Virginia |
| Authorized Official Name and Position | Telisa Lynn Kidd-wise (PRACTICE MANAGER) |
| Authorized Official Contact | 7033614278 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8715 Stonewall Road Manassas VA 20110 Ph: (703) 361-4278 | 8715 Stonewall Road Manassas VA 20110 Ph: (703) 361-4278 |
| NPI Number | 1093186512 |
|---|---|
| Provider Enumeration Date | 10/09/2015 |
| Last Update Date | 02/17/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093186512 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 0401410230 (Virginia) | Primary |
Virginia Metro Dental Services, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9161 Liberia Ave Ste 103, Manassas, VA 20110 Phone: 214-821-6468 | |
Ghazali Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8711 Digges Rd, Manassas, VA 20110 Phone: 703-368-9777 | |
Premier Dental Group Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9420 Forestwood Ln Ste 201, Manassas, VA 20110 Phone: 617-943-8812 | |
Mai Zamakhchari Dmd Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8719 Stonewall Rd, Manassas, VA 20110 Phone: 703-368-1000 Fax: 703-331-4944 |