Organization
TRUST ORTHODENT PLLC
Active
Other names
Signature Orthodontics and Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EHAB BENNASIR (MEMBER/OWNER)
(571) 260-6100
Entity
Organization
Contact information
Practice address
2701 NEABSCO COMMON PL STE 134, WOODBRIDGE, VA 22191-4189
(571) 260-6100
Mailing address
2701 NEABSCO COMMON PL STE 134, WOODBRIDGE, VA 22191-4189
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
08/21/2021
Last updated
08/21/2021
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