Ridgetop Dental Of Reston, Pllc | |
1939 Roland Clarke Pl Ste 120 Reston VA 20191-1445 | |
(571) 313-0607 | |
Not Available |
Full Name | Ridgetop Dental Of Reston, Pllc |
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Speciality | Clinic/center - Dental |
Location | 1939 Roland Clarke Pl Ste 120, Reston, Virginia |
Authorized Official Name and Position | Dattathri Malyavantham (OWNER) |
Authorized Official Contact | 5713130607 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Ridgetop Dental Of Reston, Pllc 1939 Roland Clarke Pl Ste 120 Reston VA 20191-1445 Ph: (571) 313-0607 | Ridgetop Dental Of Reston, Pllc 1939 Roland Clarke Pl Ste 120 Reston VA 20191-1445 Ph: (571) 313-0607 |
NPI Number | 1295598985 |
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Provider Enumeration Date | 02/05/2024 |
Last Update Date | 02/05/2024 |
Identifier | Type | State | Issuer |
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1295598985 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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