Organization
MANASSAS DENTAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE TAHERI DDS (OWNER)
(202) 528-1820
Entity
Organization
Contact information
Practice address
10630 CRESTWOOD DR, SUITE B, MANASSAS, VA 20109-4405
(703) 330-5578
(703) 368-1701
Mailing address
10630 CRESTWOOD DR, SUITE B, MANASSAS, VA 20109-4405
(703) 330-5578
(703) 368-1701
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10248
VA
Other
Enumeration date
05/02/2007
Last updated
08/22/2020
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