Mina Modaresi DDS PC

NPI #1851675185 in Sterling, Virginia

Provider Information

NPI Number: 1851675185
Entity Type: Organization
Organization Name: Mina Modaresi DDS PC
Primary Specialty: Dentist
Enumeration Date: Oct 5, 2011
Last Updated: Oct 5, 2011

Practice Location

Address: 45985 REGAL PLZ
Address 2: SUITE 160
City: Sterling
State: Virginia
ZIP Code: 20165-6144
Phone: (703) 433-1122

Authorized Official

Name: DR. MINA MODARESI, DDS
Title: PRESIDENT
Phone: (703) 433-1122

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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