Organization
LEESBURG MODERN DENTISTRY, PC
Active
Other names
Leesburg Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ALI SHAHRESTANI DMD (OWNER DOCTOR)
(571) 899-4713
Entity
Organization
Contact information
Practice address
502 E MARKET ST, LEESBURG, VA 20176-4112
(571) 899-4713
(571) 982-7616
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8890
(303) 952-0892
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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