South Riding Oral And Implant Surgery | |
24805 Pinebrook Rd # 318 Chantilly VA 20152-4126 | |
(571) 218-0878 | |
Not Available |
Full Name | South Riding Oral And Implant Surgery |
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Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 24805 Pinebrook Rd # 318, Chantilly, Virginia |
Authorized Official Name and Position | Kamran Raja (OWNER) |
Authorized Official Contact | 5712180878 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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South Riding Oral And Implant Surgery 9209 Marovelli Forest Dr Lorton VA 22079-3456 Ph: (571) 218-0878 | South Riding Oral And Implant Surgery 24805 Pinebrook Rd # 318 Chantilly VA 20152-4126 Ph: (571) 218-0878 |
NPI Number | 1285296814 |
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Provider Enumeration Date | 07/03/2019 |
Last Update Date | 07/03/2019 |
Identifier | Type | State | Issuer |
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1285296814 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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