Modern Orthodontics | |
10298 Bristow Center Dr Bristow VA 20136-2200 | |
(703) 436-0006 | |
Not Available |
Full Name | Modern Orthodontics |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 10298 Bristow Center Dr, Bristow, Virginia |
Authorized Official Name and Position | Nikolay Dimitrov Mollov (VICE-PRESIDENT) |
Authorized Official Contact | 7034360006 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Modern Orthodontics 10298 Bristow Center Dr Bristow VA 20136-2200 Ph: (703) 436-0006 | Modern Orthodontics 10298 Bristow Center Dr Bristow VA 20136-2200 Ph: (703) 436-0006 |
NPI Number | 1932538253 |
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Provider Enumeration Date | 11/06/2013 |
Last Update Date | 01/10/2014 |
Identifier | Type | State | Issuer |
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1932538253 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 0401413531 (Virginia) | Primary |
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