| Legacy Dental Implant Of Herndon | |
|
208 Elden St Herndon VA 20170-4877 | |
| (646) 824-3829 | |
| Not Available |
| Full Name | Legacy Dental Implant Of Herndon |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 208 Elden St, Herndon, Virginia |
| Authorized Official Name and Position | Abdelrouf Suwid (OWNER) |
| Authorized Official Contact | 6468243829 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Dental Implant Of Herndon 208 Elden St Herndon VA 20170-4877 Ph: (646) 824-3829 | Legacy Dental Implant Of Herndon 208 Elden St Herndon VA 20170-4877 Ph: (646) 824-3829 |
| NPI Number | 1053201384 |
|---|---|
| Provider Enumeration Date | 07/08/2025 |
| Last Update Date | 07/08/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053201384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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