| Innovation Dental Pllc | |
|
9070 Devlin Rd Ste 110 Bristow VA 20136 | |
| (703) 330-3933 | |
| (571) 248-2043 |
| Full Name | Innovation Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9070 Devlin Rd, Bristow, Virginia |
| Authorized Official Name and Position | Borarath M Yann (OWNER/PRESIDENT) |
| Authorized Official Contact | 7033303933 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovation Dental Pllc 9070 Devlin Rd Ste 110 Bristow VA 20136 Ph: (703) 330-3933 | Innovation Dental Pllc 9070 Devlin Rd Ste 110 Bristow VA 20136 Ph: (703) 330-3933 |
| NPI Number | 1295325991 |
|---|---|
| Provider Enumeration Date | 01/26/2021 |
| Last Update Date | 01/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295325991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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