Organization
INNOVATION DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BORARATH M YANN D.D.S. (OWNER/PRESIDENT)
(703) 330-3933
Entity
Organization
Contact information
Practice address
9070 DEVLIN RD, STE 110, BRISTOW, VA 20136
(703) 330-3933
(571) 248-2043
Mailing address
9070 DEVLIN RD, STE 110, BRISTOW, VA 20136
(703) 330-3933
(571) 248-2043
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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