Organization
KHATTAB UTHMAN DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMER KHATTAB (CONSULTANT)
(703) 348-8070
Entity
Organization
Contact information
Practice address
14338 GIDEON DR,, WOODBRIDGE, VA 22192-4640
(703) 372-5665
Mailing address
6723 DOROTHY GILES CT, ALEXANDRIA, VA 22315-6050
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401414531
VA
1223G0001X
General Practice Dentistry
Primary
0401413570
VA
Other
Enumeration date
06/27/2016
Last updated
05/04/2017
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