Organization
DIAMOND DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMAL ALI DDS (GENERAL DENTIST)
(703) 773-1212
Entity
Organization
Contact information
Practice address
13948 LEE JACKSON MEMORIAL HWY, CHANTILLY, VA 20151-3202
(703) 773-1212
(703) 773-1214
Mailing address
13948 LEE JACKSON MEMORIAL HIGHWAY, CHANTILLY, VA 20151
(703) 773-1212
(703) 773-1214
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401008860
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010378214
—
VA
Enumeration date
04/03/2012
Last updated
04/03/2012
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