Organization
FAIRFAX MODERN DENTISTRY, PC
Active
Other names
Fairfax Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI SHAHRESTANI DMD (OWNER/DMD)
(703) 520-6376
Entity
Organization
Contact information
Practice address
11050 LEE HWY, FAIRFAX, VA 22030-5014
(703) 520-6376
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8280
(303) 952-0892
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/25/2018
Last updated
08/05/2022
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