Organization
HERNDON DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AYESAN HEMATI DDS (PROSTHODONTIST)
(678) 906-8367
Entity
Organization
Contact information
Practice address
12973 HIGHLAND CROSSING DR STE B, HERNDON, VA 20171-5890
(678) 906-8367
Mailing address
12973 HIGHLAND CROSSING DR STE B, HERNDON, VA 20171-5890
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/18/2020
Last updated
12/18/2020
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