Organization
AMERICAN DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AICHA LYAZIDI (DENTIST)
(703) 533-7285
Entity
Organization
Contact information
Practice address
105 N VIRGINIA AVE STE 103, FALLS CHURCH, VA 22046-3323
(703) 533-7285
Mailing address
105 N VIRGINIA AVE STE 103, FALLS CHURCH, VA 22046-3323
(703) 533-7285
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401410695
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922189174
—
VA
Enumeration date
11/03/2016
Last updated
11/03/2016
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