| NPI | 1497626121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI SEENA YAZDANI Dentist 571-354-5115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2025-09-16 |
| Last Update Date | 2025-09-16 |