MEDICARE: A TO Z DENTAL CARE PC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1245076678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A TO Z DENTAL CARE PC INC

Provider Business Mailing Address
First Line	:	9439 SMOKEY BEAR CT
Second Line	:
City	:	BRISTOW
State	:	VA
Zip	:	20136-5100
Country	:	US
Telephone Number	:	703-618-3184
Fax Number	:

Provider Business Practice Location Address
First Line	:	4152 DALE BLVD
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22193-2225
Country	:	US
Telephone Number	:	703-618-3184
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SYEDA AMNA ZAIM
Credential	:	DDS
Telephone Number	:	703-618-3184

Provider Enumeration Date	:	07/04/2024
Last Update Date	:	07/04/2024

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