| Dr Mib Dds Pllc | |
|
12973 Highland Crossing Dr Ste B Herndon VA 20171-5890 | |
| (703) 953-3307 | |
| Not Available |
| Full Name | Dr Mib Dds Pllc |
|---|---|
| Speciality | Dentist |
| Location | 12973 Highland Crossing Dr Ste B, Herndon, Virginia |
| Authorized Official Name and Position | Mohamed Ibrahim (OWNER) |
| Authorized Official Contact | 7036248188 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mib Dds Pllc 401 12th St S Apt 1712 Arlington VA 22202-4237 Ph: (703) 624-8188 | Dr Mib Dds Pllc 12973 Highland Crossing Dr Ste B Herndon VA 20171-5890 Ph: (703) 953-3307 |
| NPI Number | 1902487150 |
|---|---|
| Provider Enumeration Date | 04/19/2021 |
| Last Update Date | 04/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902487150 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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