| Institute Of Facial & Oral Surgery | |
|
44115 Woodridge Pkwy Suite 200 Leesburg VA 20176-5199 | |
| (703) 729-0077 | |
| (703) 729-6696 |
| Full Name | Institute Of Facial & Oral Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 44115 Woodridge Pkwy, Leesburg, Virginia |
| Authorized Official Name and Position | Suketu I Patel (PART OWNER) |
| Authorized Official Contact | 7037290077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Institute Of Facial & Oral Surgery 44115 Woodridge Pkwy Suite 200 Leesburg VA 20176-5199 Ph: (703) 729-0077 | Institute Of Facial & Oral Surgery 44115 Woodridge Pkwy Suite 200 Leesburg VA 20176-5199 Ph: (703) 729-0077 |
| NPI Number | 1225305766 |
|---|---|
| Provider Enumeration Date | 11/29/2011 |
| Last Update Date | 11/29/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225305766 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 0401413011 (Virginia) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 101238043 (Virginia) | Secondary |
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