Organization
PRIME FAMILY DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUBHA C YERABOLLU DDS (DENTIST)
(703) 403-1304
Entity
Organization
Contact information
Practice address
24805 PINEBROOK RD # 316, CHANTILLY, VA 20152-4126
(703) 403-1304
Mailing address
22917 EMERALD CHASE PL, ASHBURN, VA 20148-6446
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/23/2018
Last updated
02/23/2018
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