| Woodbridge Periodontal & Implant Center Pllc | |
|
2200 Opitz Blvd Ste 205 Woodbridge VA 22191-3343 | |
| (703) 491-2974 | |
| Not Available |
| Full Name | Woodbridge Periodontal & Implant Center Pllc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2200 Opitz Blvd Ste 205, Woodbridge, Virginia |
| Authorized Official Name and Position | Ahmad Hawasli (PERIODONTIST) |
| Authorized Official Contact | 7736290329 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodbridge Periodontal & Implant Center Pllc 2200 Opitz Blvd # 205 Woodbridge VA 22191 Ph: () - | Woodbridge Periodontal & Implant Center Pllc 2200 Opitz Blvd Ste 205 Woodbridge VA 22191-3343 Ph: (703) 491-2974 |
| NPI Number | 1144743709 |
|---|---|
| Provider Enumeration Date | 07/25/2017 |
| Last Update Date | 08/04/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144743709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 0401414973 (Virginia) | Primary |
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