| Nova Family Dentist | |
|
14165 Robert Paris Ct Ste A Chantilly VA 20151-4243 | |
| (703) 953-3343 | |
| (703) 956-6974 |
| Full Name | Nova Family Dentist |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 14165 Robert Paris Ct Ste A, Chantilly, Virginia |
| Authorized Official Name and Position | Jyothi Koneru (PRESIENT&CEO) |
| Authorized Official Contact | 7039533343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Family Dentist 14165 Robert Paris Ct Ste A Chantilly VA 20151-4243 Ph: (703) 953-3343 | Nova Family Dentist 14165 Robert Paris Ct Ste A Chantilly VA 20151-4243 Ph: (703) 953-3343 |
| NPI Number | 1649555673 |
|---|---|
| Provider Enumeration Date | 10/21/2011 |
| Last Update Date | 10/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649555673 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401410786 (Virginia) | Primary |
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