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Organization
LEESBURG DENTAL AND ORTHODONTICS, PLLC
Active
Organization
LEESBURG DENTAL AND ORTHODONTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZACK HICHAM MEKOUAR DDS (PRESIDENT)
(703) 347-1282
Entity
Organization
Contact information
Practice address
135 ROBINSON MILL PLZ SE STE 108, LEESBURG, VA 20175-4797
(703) 347-1282
Mailing address
9616 GEORGETOWN PIKE, GREAT FALLS, VA 22066-2638
(703) 347-1282
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
NULL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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