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Organization
RESTON FAMILY DENTIST GROUP PLLC
Active
Organization
RESTON FAMILY DENTIST GROUP PLLC
Active
Other names
Reston Family Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI MIAMEE DDS (PRESIDENT)
(571) 423-7945
Entity
Organization
Contact information
Practice address
1801 ROBERT FULTON DR, SUITE 100, RESTON, VA 20191-5461
(571) 423-7945
(571) 313-0576
Mailing address
12025 TOWN SQUARE ST, UNIT 424, RESTON, VA 20190-6026
(571) 423-7945
(571) 313-0576
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401412603
VA
1223P0300X
Periodontics
0401412603
VA
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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