Individual
MRS. MASTORA N IBRAHIMKHIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
163 FORT EVANS RD NE, LEESBURG, VA 20176-4420
(703) 443-2000
(703) 771-4120
Mailing address
163 FORT EVANS RD NE, LEESBURG, VA 20176-4420
(703) 443-2000
(703) 771-4120
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
0402202407
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VIRGINIA
—
VA
Enumeration date
03/10/2016
Last updated
03/10/2016
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