Organization
LEESBURG PREMIER DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD SHARIFUL AMAN DMD (PRESIDENT)
(703) 687-4861
Entity
Organization
Contact information
Practice address
161 FORT EVANS RD NE, SUITE- 300, LEESBURG, VA 20176
(703) 687-4861
Mailing address
161 FORT EVANS RD NE, SUITE- 300, LEESBURG, VA 20176
(703) 687-4861
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401412500
VA
Other
Enumeration date
10/13/2014
Last updated
02/10/2015
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