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Organization
INSTITUTE OF FACIAL & ORAL SURGERY
Active
Organization
INSTITUTE OF FACIAL & ORAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUKETU I PATEL M.D., D.M.D. (PART OWNER)
(703) 729-0077
Entity
Organization
Contact information
Practice address
44115 WOODRIDGE PKWY, SUITE 200, LEESBURG, VA 20176-5199
(703) 729-0077
(703) 729-6696
Mailing address
44115 WOODRIDGE PKWY, SUITE 200, LEESBURG, VA 20176-5199
(703) 729-0077
(703) 729-6696
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401413011
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
101238043
VA
Other
Enumeration date
11/29/2011
Last updated
11/29/2011
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