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Organization
WOODBRIDGE PERIODONTAL & IMPLANT CENTER PLLC
Active
Organization
WOODBRIDGE PERIODONTAL & IMPLANT CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AHMAD HAWASLI DDS, MSC (PERIODONTIST)
(773) 629-0329
Entity
Organization
Contact information
Practice address
2200 OPITZ BLVD STE 205, WOODBRIDGE, VA 22191-3343
(703) 491-2974
Mailing address
2200 OPITZ BLVD, # 205, WOODBRIDGE, VA 22191
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0401414973
VA
Other
Enumeration date
07/25/2017
Last updated
08/04/2017
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