| My Braces Doctor, Pc | |
|
10721 Main St #300 Fairfax VA 22030-6914 | |
| (703) 591-6686 | |
| (703) 277-7674 |
| Full Name | My Braces Doctor, Pc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 10721 Main St, Fairfax, Virginia |
| Authorized Official Name and Position | Nahid N Sina (PRES) |
| Authorized Official Contact | 7039667959 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Braces Doctor, Pc 10721 Main St #300 Fairfax VA 22030-6914 Ph: (703) 591-6686 | My Braces Doctor, Pc 10721 Main St #300 Fairfax VA 22030-6914 Ph: (703) 591-6686 |
| NPI Number | 1285807370 |
|---|---|
| Provider Enumeration Date | 04/09/2008 |
| Last Update Date | 04/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285807370 | NPI | - | NPPES |
| LOCATION ID: 010495 | Medicaid | VA | |
| PROVIDER NO: 0012081 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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