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General NPI Number Information
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NPI Number | 1548663347
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Entity Type | Organization
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Legal Business Name | ERIC MESTAS DDS PC
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Dates
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Enumeration Date | 10/07/2014
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Last Update Date | 10/08/2014
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Provider Practice Location Address
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Address Line | 5115 FRANCONIA RD STE -D
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City | ALEXANDRIA
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State | VA
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Zip | 22310
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Country | US
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Telephone | 703-971-2788
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Fax | 703-922-9427
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Provider Business Mailing Address
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Address Line | 5115 FRANCONIA RD STE -D
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City | ALEXANDRIA
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State | VA
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Zip | 22310
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Country | US
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Telephone | 703-971-2788
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Fax | 703-922-9427
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Authorized Official
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Title or Position | FRONT DESK MANAGER
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Name | MARIELA ESCALERA
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Credential |
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Telephone | 703-971-2788
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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 |
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License Number State |
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