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Organization

KOUROS HEDAYATI, DDS, PLC

Active
Other names
Breeze Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KOUROS HEDAYATI DDS (OWNER/DENTIST)
(571) 225-1038
Entity
Organization

Contact information

Practice address
3545 CHAIN BRIDGE RD STE 5, FAIRFAX, VA 22030-2708
(703) 273-5545
(703) 591-8702
Mailing address
3545 CHAIN BRIDGE RD STE 5, FAIRFAX, VA 22030-2708
(703) 273-5545
(703) 591-8702

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401412201
VA

Other

Enumeration date
04/18/2017
Last updated
04/18/2017
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