Organization
ROOT MODERN DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISKA MUSTAFA DDS (OWNER/DENTIST)
(202) 489-5972
Entity
Organization
Contact information
Practice address
250 N WASHINGTON HWY STE A, ASHLAND, VA 23005-1624
(804) 406-4404
Mailing address
122 LAURADELL RD, ASHLAND, VA 23005-8228
(202) 489-5972
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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