Individual
MITA DULABH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
2970 PRINCE WILLIAM PKWY, WOODBRIDGE, VA 22192-4145
(703) 583-7720
Mailing address
5587 CALLCOTT WAY, APT 1102, ALEXANDRIA, VA 22312-4009
(859) 576-5459
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401412184
VA
Other
Enumeration date
07/11/2007
Last updated
05/20/2009
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