Provider Demographics
NPI:1548663347
Name:ERIC MESTAS DDS PC
Entity type:Organization
Organization Name:ERIC MESTAS DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT DESK MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCALERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-971-2788
Mailing Address - Street 1:5115 FRANCONIA RD STE -D
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310
Mailing Address - Country:US
Mailing Address - Phone:703-971-2788
Mailing Address - Fax:703-922-9427
Practice Address - Street 1:5115 FRANCONIA RD STE -D
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310
Practice Address - Country:US
Practice Address - Phone:703-971-2788
Practice Address - Fax:703-922-9427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental