| Leesburg Premier Dental | |
|
161 Fort Evans Rd Ne Suite- 300 Leesburg VA 20176 | |
| (703) 687-4861 | |
| Not Available |
| Full Name | Leesburg Premier Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 161 Fort Evans Rd Ne, Leesburg, Virginia |
| Authorized Official Name and Position | Mohammad Shariful Aman (PRESIDENT) |
| Authorized Official Contact | 7036874861 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leesburg Premier Dental 161 Fort Evans Rd Ne Suite- 300 Leesburg VA 20176 Ph: (703) 687-4861 | Leesburg Premier Dental 161 Fort Evans Rd Ne Suite- 300 Leesburg VA 20176 Ph: (703) 687-4861 |
| NPI Number | 1346644838 |
|---|---|
| Provider Enumeration Date | 10/13/2014 |
| Last Update Date | 02/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346644838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401412500 (Virginia) | Primary |
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