MEDICARE: DR. MARJAN PARTOVI DDS

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	1223G0001X	General Practice Dentistry	0401410378	VA

General Provider Information

NPI Number	:	1588611776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARJAN PARTOVI DDS

Provider Business Mailing Address
First Line	:	7806 CENTREVILLE RD
Second Line	:
City	:	MANASSAS
State	:	VA
Zip	:	20111-2231
Country	:	US
Telephone Number	:	703-368-1166
Fax Number	:	703-331-0356

Provider Business Practice Location Address
First Line	:	7806 CENTREVILLE RD
Second Line	:
City	:	MANASSAS
State	:	VA
Zip	:	20111-2231
Country	:	US
Telephone Number	:	703-368-1166
Fax Number	:	703-331-0356

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	07/08/2007

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