| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 02/05/2024 |
| Last Update Date | 02/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295598985 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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