| Roxanne Azmoudeh, D.d.s. P. C. | |
|
44355 Premier Plz Ste 100 Ashburn VA 20147-5050 | |
| (703) 858-9146 | |
| (703) 858-9147 |
| Full Name | Roxanne Azmoudeh, D.d.s. P. C. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 44355 Premier Plz Ste 100, Ashburn, Virginia |
| Authorized Official Name and Position | Roxanne Azmoudeh (PRESIDENT) |
| Authorized Official Contact | 7038589146 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roxanne Azmoudeh, D.d.s. P. C. 44355 Premier Plz Ste 100 Ashburn VA 20147-5050 Ph: (703) 858-9146 | Roxanne Azmoudeh, D.d.s. P. C. 44355 Premier Plz Ste 100 Ashburn VA 20147-5050 Ph: (703) 858-9146 |
| NPI Number | 1366937096 |
|---|---|
| Provider Enumeration Date | 06/26/2018 |
| Last Update Date | 06/26/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366937096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 0401410979 (Virginia) | Primary |
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