Tysons Modern Dentistry, Pc | |
8393 Leesburg Pike Vienna VA 22182-2402 | |
(703) 745-1797 | |
Not Available |
Full Name | Tysons Modern Dentistry, Pc |
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Speciality | Dentist - General Practice |
Location | 8393 Leesburg Pike, Vienna, Virginia |
Authorized Official Name and Position | Ali Shahrestani (OWNER) |
Authorized Official Contact | 7148458500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Tysons Modern Dentistry, Pc Po Box 920050 Dallas TX 75392-0050 Ph: () - | Tysons Modern Dentistry, Pc 8393 Leesburg Pike Vienna VA 22182-2402 Ph: (703) 745-1797 |
NPI Number | 1508512708 |
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Provider Enumeration Date | 02/25/2022 |
Last Update Date | 02/25/2022 |
Identifier | Type | State | Issuer |
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1508512708 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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