Kouros Hedayati, Dds, Plc

NPI #1639603459 in Fairfax, Virginia

Provider Information

NPI Number: 1639603459
Entity Type: Organization
Organization Name: Kouros Hedayati, Dds, Plc
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 18, 2017
Last Updated: Apr 18, 2017

Practice Location

Address: 3545 CHAIN BRIDGE RD STE 5
City: Fairfax
State: Virginia
ZIP Code: 22030-2708
Phone: (703) 273-5545

Authorized Official

Name: DR. KOUROS HEDAYATI, DDS
Title: OWNER/DENTIST
Phone: (571) 225-1038

Specialties & Taxonomy Codes

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

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