Individual
NOUR HUSSAM TELLAWI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6000 STEVENSON AVE STE 103, ALEXANDRIA, VA 22304-3526
(571) 297-2855
Mailing address
6000 STEVENSON AVE STE 103, ALEXANDRIA, VA 22304-3526
(571) 297-2855
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401417173
VA
Other
Enumeration date
09/21/2020
Last updated
12/04/2020
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