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Individual

DR. KOUROS HEDAYATI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
3545 CHAIN BRIDGE RD STE 105, FAIRFAX, VA 22030-2708
(703) 273-5545
(703) 273-5545
Mailing address
2624 AMANDA CT, VIENNA, VA 22180-6834
(571) 225-1038

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401412201
VA

Other

Enumeration date
07/02/2008
Last updated
12/06/2022
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