NPI 1063799765

Ayesha Sultan DDS PC

Organisation Preferred Provider Organization Manassas, VA

Practice location

Address: 6312 Hoadly Rd, Manassas, VA 20112-3422
Phone: (703) 220-9984
Mailing address: 14260 Holly Glen CT, Manassas, VA 20112-7011

Authorised official

Name: Ayesha Sultan
Title: Dentist
Phone: (703) 220-9984

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 0401412555 (VA)

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Registry record

NPI: 1063799765
Entity type: Organization
NPI issued: 8 Nov 2011
Record last updated: 8 Nov 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.