Organization
LORTONTOWN DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMER KHATTAB DDS (CEO)
(703) 372-5665
Entity
Organization
Contact information
Practice address
9010 LORTON STATION BLVD STE 135, LORTON, VA 22079-4794
(703) 372-5665
(703) 372-5684
Mailing address
9010 LORTON STATION BLVD STE 135, LORTON, VA 22079-4794
(703) 372-5665
(703) 372-5684
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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