Organization
AVATAR DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TALIB SALIM ALI DMD (MANAGING DOCTOR)
(703) 669-8600
Entity
Organization
Contact information
Practice address
545 E MARKET ST STE G, LEESBURG, VA 20176-4172
(703) 669-8600
Mailing address
545 E MARKET ST STE G, LEESBURG, VA 20176-4172
(703) 669-8600
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0401412553
VA
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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