Individual
MOJGAN KAKROUDI JAMALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
10630 CRESTWOOD DR, SUITE B, MANASSAS, VA 20109-4405
(703) 330-5578
Mailing address
2251 PIMMIT DR, #1426, FALLS CHURCH, VA 22043-2811
(443) 463-2883
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401410946
VA
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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