Organization
IDEAL ENDODONTICS OF WOODBRIDGE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOEIN JABBAR DARJANI DDS (OWNER)
(310) 402-4038
Entity
Organization
Contact information
Practice address
3102 GOLANSKY BLVD STE 101, WOODBRIDGE, VA 22192-4244
(571) 991-3700
Mailing address
3102 GOLANSKY BLVD STE 101, WOODBRIDGE, VA 22192-4244
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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