| NPI | 1932837101 |
|---|---|
| Doing Business As | LEESBURG MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ALI SHAHRESTANI Owner Doctor 571-899-4713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-08-15 |
| Last Update Date | 2022-08-15 |