Organization
ASHBURN ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAHIRA KORTAM DDS, MSC, MS (DR./ORTHODONTIST)
(347) 761-7199
Entity
Organization
Contact information
Practice address
44345 PREMIER PLZ, SUITE 140, ASHBURN, VA 20147-5053
(347) 761-7199
Mailing address
44345 PREMIER PLZ, SUITE 140, ASHBURN, VA 20147-5053
(347) 761-7199
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0401412813
VA
Other
Enumeration date
02/24/2011
Last updated
02/24/2011
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