Organization
GHANBARI & KOSHKI, DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY ANN SPICER (OFFICE MANAGER)
(703) 803-9200
Entity
Organization
Contact information
Practice address
5727 CENTRE SQUARE DR, CENTREVILLE, VA 20120-1916
(703) 803-9200
(703) 803-9419
Mailing address
5727 CENTRE SQUARE DR, CENTREVILLE, VA 20120-1916
(703) 803-9200
(703) 803-9419
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
BG3069348
VA
Other
Enumeration date
07/20/2006
Last updated
07/10/2007
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