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Organization
BLOSSOM SMILE OF WOODBRIDGE PLLC
Active
Organization
BLOSSOM SMILE OF WOODBRIDGE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUSSEIN ALHASAN DDS, MSD (CEO)
(916) 622-2098
Entity
Organization
Contact information
Practice address
12618 LAKE RIDGE DR, WOODBRIDGE, VA 22192-2335
(916) 622-2098
Mailing address
6800 FLEETWOOD RD APT 1001, MC LEAN, VA 22101-3610
(916) 622-2098
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
NULL
1223G0001X
General Practice Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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