| Reston Family Dental Center | |
|
1801 Robert Fulton Dr Suite 100 Reston VA 20191-5461 | |
| (571) 423-7945 | |
| (571) 313-0576 |
| Full Name | Reston Family Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1801 Robert Fulton Dr, Reston, Virginia |
| Authorized Official Name and Position | Ali Miamee (PRESIDENT) |
| Authorized Official Contact | 5714237945 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reston Family Dental Center 12025 Town Square St Unit 424 Reston VA 20190-6026 Ph: (571) 423-7945 | Reston Family Dental Center 1801 Robert Fulton Dr Suite 100 Reston VA 20191-5461 Ph: (571) 423-7945 |
| NPI Number | 1265884423 |
|---|---|
| Provider Enumeration Date | 07/12/2016 |
| Last Update Date | 07/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265884423 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401412603 (Virginia) | Primary |
| 1223P0300X | Dentist - Periodontics | 0401412603 (Virginia) | Secondary |
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