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Organization
MINA MODARESI DDS PC
Active
Organization
MINA MODARESI DDS PC
Active
Other names
Regal Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MINA MODARESI DDS (PRESIDENT)
(703) 433-1122
Entity
Organization
Contact information
Practice address
45985 REGAL PLZ, SUITE 160, STERLING, VA 20165-6144
(703) 433-1122
(703) 433-0907
Mailing address
45985 REGAL PLZ, SUITE 160, STERLING, VA 20165-6144
(703) 433-1122
(703) 433-0907
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401410066
VA
Other
Enumeration date
10/05/2011
Last updated
10/05/2011
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