Individual
DR. REZA FARDSHISHEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6120 BRANDON AVE STE 314, SPRINGFIELD, VA 22150-2504
(703) 569-0002
(703) 569-8758
Mailing address
11359 SUNSET HILLS RD, RESTON, VA 20190-5275
(703) 437-6666
(703) 435-8281
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
0401411770
VA
Other
Enumeration date
06/21/2007
Last updated
07/08/2007
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