Organization
ARTISTE DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARA MOSHIRI DDS (OWNER)
(703) 434-3286
Entity
Organization
Contact information
Practice address
46090 LAKE CENTER PLZ, SUITE 107, STERLING, VA 20165-5876
(703) 434-3286
Mailing address
46090 LAKE CENTER PLZ, SUITE 107, STERLING, VA 20165-5876
(703) 434-3286
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401410136
VA
1223G0001X
General Practice Dentistry
0401410136
VA
Other
Enumeration date
12/09/2011
Last updated
12/09/2011
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