Organization
RESTON FAMILY DENTIST GROUP PLLC
Active
Other names
Reston Family Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI MIAMEE DDS (PRESIDENT)
(571) 423-7945
Entity
Organization
Contact information
Practice address
1801 ROBERT FULTON DR, SUITE 100, RESTON, VA 20191-5461
(571) 423-7945
(571) 313-0576
Mailing address
12025 TOWN SQUARE ST, UNIT 424, RESTON, VA 20190-6026
(571) 423-7945
(571) 313-0576
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401412603
VA
1223P0300X
Periodontics
0401412603
VA
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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