Organization
LEESBURG DENTAL AND ORTHODONTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZACK HICHAM MEKOUAR DDS (PRESIDENT)
(703) 347-1282
Entity
Organization
Contact information
Practice address
135 ROBINSON MILL PLZ SE STE 108, LEESBURG, VA 20175-4797
(703) 347-1282
Mailing address
9616 GEORGETOWN PIKE, GREAT FALLS, VA 22066-2638
(703) 347-1282
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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