Organization
JASON FARR FAVAGEHI DDS III PC
Active
Other names
Chantilly Dental Arts Center
Organization subpart
No
Provider details
NPI number
Authorized official
JASON FARR FAVAGEHI DDS (PRESIDENT)
(703) 356-1200
Entity
Organization
Contact information
Practice address
13655 A LEE JACKSON MEM HWY, CHANTILLY, VA 20151
(703) 263-7222
(703) 263-2276
Mailing address
13655 A LEE JACKSON MEM HWY, CHANTILLY, VA 20151
(703) 263-7222
(703) 263-2276
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401007352
VA
Other
Enumeration date
01/17/2007
Last updated
08/22/2020
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