Organization
ELGHANNAM DENTAL LLC
Active
Other names
WOODBRIDGE FAMLIY AND IMPLANT Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED M ELGHANNAM (CEO)
(615) 499-0438
Entity
Organization
Contact information
Practice address
4421 DALE BLVD STE 202, WOODBRIDGE, VA 22193-2550
(615) 499-0438
Mailing address
4421 DALE BLVD STE 202, WOODBRIDGE, VA 22193-2550
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/20/2025
Last updated
01/22/2025
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