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Organization
ANH H PHAM DDS & BARRY R MAHARAJ DDS PC
Active
Organization
ANH H PHAM DDS & BARRY R MAHARAJ DDS PC
Active
Other names
Chantilly Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAITI ROSE GRIM CMOM CERT MEDICAL OF (ADMINISTRATIVE DIRECTOR)
(703) 668-9494
Entity
Organization
Contact information
Practice address
3910 CENTERVILLE RD, STE 110, CHANTILLY, VA 20151-3280
(703) 668-9494
(703) 668-9495
Mailing address
3910 CENTERVILLE RD, STE 110, CHANTILLY, VA 20151-3280
(703) 668-9494
(703) 668-9495
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401006304
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
0401410305
VA
Other
Enumeration date
08/20/2006
Last updated
06/27/2013
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