Organization
FAIR LAKES DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH DEHYAR D.M.D. (OWNER)
(703) 764-0650
Entity
Organization
Contact information
Practice address
12989 FAIR LAKES PKWY, FAIRFAX, VA 22033
(703) 222-1230
Mailing address
9534 BURKE ROAD, BURKE, VA 22015
(703) 764-0650
(703) 764-1772
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411034
VA
Other
Enumeration date
09/03/2009
Last updated
09/03/2009
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