South Riding Modern Dentistry, PC

NPI #1982178620 in Chantilly, Virginia

Provider Information

NPI Number: 1982178620
Entity Type: Organization
Organization Name: South Riding Modern Dentistry, PC
Primary Specialty: Dentist
Enumeration Date: Jan 16, 2019
Last Updated: Jan 16, 2019

Practice Location

Address: 25421 LIZZIO CENTER DR.
Address 2: SUITE 190
City: Chantilly
State: Virginia
ZIP Code: 20152
Phone: (703) 543-3724

Authorized Official

Name: DR. ALEX R SHARIFIAN, DDS
Title: OWNER/DDS
Phone: (703) 543-9724

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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