Organization
NOVA AFFORDABLE DENTAL IMPLANT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AHMED MATRI (OWNER)
(646) 824-3829
Entity
Organization
Contact information
Practice address
8209 SUDLEY RD, MANASSAS, VA 20109-3507
(571) 260-6222
Mailing address
8209 SUDLEY RD, MANASSAS, VA 20109-3507
(646) 824-3829
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
02/17/2022
Last updated
02/17/2022
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