Modaresi & Avin DDS Pllc

NPI #1477160547 in Chantilly, Virginia

Provider Information

NPI Number: 1477160547
Entity Type: Organization
Organization Name: Modaresi & Avin DDS Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Sep 23, 2020
Last Updated: Sep 23, 2020

Practice Location

Address: 24805 PINEBROOK RD STE 112
City: Chantilly
State: Virginia
ZIP Code: 20152-4127
Phone: (571) 334-8209

Authorized Official

Name: DR. MINA MODARESI, DDS
Title: OWNER
Phone: (571) 334-8209

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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