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General NPI Number Information
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NPI Number | 1487876538
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Entity Type | Organization
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Legal Business Name | MAIN STREET FAMILY DENTISTRY PC
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 850-D EAST MAIN STREET
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City | PURCELLVILLE
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State | VA
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Zip | 20132
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Country | US
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Telephone | 540-751-2221
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Fax | 540-751-2218
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Provider Business Mailing Address
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Address Line | 850-D EAST MAIN STREET
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City | PURCELLVILLE
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State | VA
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Zip | 20132
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Country | US
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Telephone | 540-751-2221
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Fax | 540-751-2218
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALLEN A ZARRINFAR
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Credential | DDS
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Telephone | 540-751-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 0401411107
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License Number State | VA
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