| Elite Dental Care, P.c. | |
|
23520 Overland Dr Suite 134 Dulles VA 20166-2196 | |
| (703) 661-6380 | |
| Not Available |
| Full Name | Elite Dental Care, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 23520 Overland Dr, Dulles, Virginia |
| Authorized Official Name and Position | Khalid Mansour Hussein (PRESIDENT) |
| Authorized Official Contact | 7036616380 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Dental Care, P.c. 23520 Overland Dr Suite 134 Dulles VA 20166-2196 Ph: (703) 661-6380 | Elite Dental Care, P.c. 23520 Overland Dr Suite 134 Dulles VA 20166-2196 Ph: (703) 661-6380 |
| NPI Number | 1407026156 |
|---|---|
| Provider Enumeration Date | 03/10/2008 |
| Last Update Date | 03/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407026156 | NPI | - | NPPES |
| 9180007 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401411564 (Virginia) | Primary |
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