| Modaresi & Avin Dds Pllc | |
|
24805 Pinebrook Rd Ste 112 Chantilly VA 20152-4127 | |
| (571) 334-8209 | |
| Not Available |
| Full Name | Modaresi & Avin Dds Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 24805 Pinebrook Rd Ste 112, Chantilly, Virginia |
| Authorized Official Name and Position | Mina Modaresi (OWNER) |
| Authorized Official Contact | 5713348209 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modaresi & Avin Dds Pllc 24805 Pinebrook Rd Ste 112 Chantilly VA 20152-4127 Ph: (571) 334-8209 | Modaresi & Avin Dds Pllc 24805 Pinebrook Rd Ste 112 Chantilly VA 20152-4127 Ph: (571) 334-8209 |
| NPI Number | 1477160547 |
|---|---|
| Provider Enumeration Date | 09/23/2020 |
| Last Update Date | 09/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477160547 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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