Organization
ANGEL HEART & SOUL DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEMARI DE LEON IMAO DMD (OWNER/DENTIST)
(585) 354-1168
Entity
Organization
Contact information
Practice address
2942 PATRICK HENRY DR, FALLS CHURCH, VA 22044-2904
(703) 533-8808
(703) 533-8420
Mailing address
2942 PATRICK HENRY DR, FALLS CHURCH, VA 22044-2904
(703) 533-8808
(703) 533-8420
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401412284
VA
Other
Enumeration date
04/13/2015
Last updated
04/13/2015
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