Tysons Modern Dentistry, PC

NPI #1508512708 in Vienna, Virginia

Provider Information

NPI Number: 1508512708
Entity Type: Organization
Organization Name: Tysons Modern Dentistry, PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 25, 2022
Last Updated: Feb 25, 2022

Practice Location

Address: 8393 LEESBURG PIKE
City: Vienna
State: Virginia
ZIP Code: 22182-2402
Phone: (703) 745-1797

Authorized Official

Name: ALI SHAHRESTANI
Title: OWNER
Phone: (714) 845-8500

Specialties & Taxonomy Codes

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

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