Provider Demographics
NPI:1144062324
Name:NOVA FAMILY DENTAL CENTER
Entity type:Organization
Organization Name:NOVA FAMILY DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYRUS
Authorized Official - Middle Name:
Authorized Official - Last Name:AREFI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:301-337-9319
Mailing Address - Street 1:3533 COLUMBIA PIKE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-4213
Mailing Address - Country:US
Mailing Address - Phone:703-705-9003
Mailing Address - Fax:703-646-0964
Practice Address - Street 1:3533 COLUMBIA PIKE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-4213
Practice Address - Country:US
Practice Address - Phone:703-705-9003
Practice Address - Fax:703-646-0964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty