| Prime Family Dentistry, Pllc | |
|
24805 Pinebrook Rd # 316 Chantilly VA 20152-4126 | |
| (703) 403-1304 | |
| Not Available |
| Full Name | Prime Family Dentistry, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 24805 Pinebrook Rd # 316, Chantilly, Virginia |
| Authorized Official Name and Position | Subha C Yerabollu (DENTIST) |
| Authorized Official Contact | 7034031304 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Family Dentistry, Pllc 22917 Emerald Chase Pl Ashburn VA 20148-6446 Ph: () - | Prime Family Dentistry, Pllc 24805 Pinebrook Rd # 316 Chantilly VA 20152-4126 Ph: (703) 403-1304 |
| NPI Number | 1255832234 |
|---|---|
| Provider Enumeration Date | 02/23/2018 |
| Last Update Date | 02/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255832234 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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