Provider Demographics
NPI:1093272155
Name:MENA BOTROS DDS PLLC
Entity type:Organization
Organization Name:MENA BOTROS DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTROS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-465-3399
Mailing Address - Street 1:116 FOUNDERS WAY STE 1
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22657-3772
Mailing Address - Country:US
Mailing Address - Phone:540-465-3399
Mailing Address - Fax:540-465-3397
Practice Address - Street 1:116 FOUNDERS WAY STE 1
Practice Address - Street 2:
Practice Address - City:STRASBURG
Practice Address - State:VA
Practice Address - Zip Code:22657-3772
Practice Address - Country:US
Practice Address - Phone:540-465-3399
Practice Address - Fax:540-465-3397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental