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General NPI Number Information
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NPI Number | 1730391723
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Entity Type | Organization
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Legal Business Name | DULLES DENTAL CENTER, P.C.
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 01/08/2009
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Provider Practice Location Address
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Address Line | 1035 STERLING RD SUITE 204
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City | HERNDON
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State | VA
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Zip | 20170-3868
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Country | US
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Telephone | 703-471-8080
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Fax | 703-471-5354
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Provider Business Mailing Address
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Address Line | 1035 STERLING RD SUITE 204
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City | HERNDON
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State | VA
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Zip | 20170-3838
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Country | US
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Telephone | 703-471-8080
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Fax | 703-471-5354
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. FIROUZEH ABBASSI
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Credential |
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Telephone | 703-471-8080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401007323
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License Number State | VA
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