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Organization
ADVANCED DENTAL ANESTHESIA PLLC
Active
Organization
ADVANCED DENTAL ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REZA IZADI DO (OWNER)
(202) 265-0508
Entity
Organization
Contact information
Practice address
10611 BRADDOCK RD, FAIRFAX, VA 22032-2201
(202) 265-0805
Mailing address
2776 S ARLINGTON MILL DR # 121, ARLINGTON, VA 22206-3402
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
FI5268405
VA
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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