Organization
MINA MODARESI DDS PC
Active
Other names
Regal Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MINA MODARESI DDS (PRESIDENT)
(703) 433-1122
Entity
Organization
Contact information
Practice address
45985 REGAL PLZ, SUITE 160, STERLING, VA 20165-6144
(703) 433-1122
(703) 433-0907
Mailing address
45985 REGAL PLZ, SUITE 160, STERLING, VA 20165-6144
(703) 433-1122
(703) 433-0907
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401410066
VA
Other
Enumeration date
10/05/2011
Last updated
10/05/2011
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