| Ryan Park Dentistry | |
|
43480 Yukon Dr Suite 204 Ashburn VA 20147-6988 | |
| (703) 729-8277 | |
| (703) 729-8774 |
| Full Name | Ryan Park Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 43480 Yukon Dr, Ashburn, Virginia |
| Authorized Official Name and Position | Estela Pena (OWNER) |
| Authorized Official Contact | 7037298277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ryan Park Dentistry 43480 Yukon Dr Suite 204 Ashburn VA 20147-6988 Ph: (703) 729-8277 | Ryan Park Dentistry 43480 Yukon Dr Suite 204 Ashburn VA 20147-6988 Ph: (703) 729-8277 |
| NPI Number | 1700079373 |
|---|---|
| Provider Enumeration Date | 08/27/2007 |
| Last Update Date | 08/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700079373 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 0401410933 (Virginia) | Primary |
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