Modern Orthodontics

NPI #1932538253 in Bristow, Virginia

Provider Information

NPI Number: 1932538253
Entity Type: Organization
Organization Name: Modern Orthodontics
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Nov 6, 2013
Last Updated: Jan 10, 2014

Practice Location

Address: 10298 BRISTOW CENTER DR
City: Bristow
State: Virginia
ZIP Code: 20136-2200
Phone: (703) 436-0006

Authorized Official

Name: DR. NIKOLAY DIMITROV MOLLOV, DDS, MS
Title: VICE-PRESIDENT
Phone: (703) 436-0006

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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