Organization
THE TOOTH DOC FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMANEY AHMAD DMD (DENTIST)
(703) 793-0291
Entity
Organization
Contact information
Practice address
2465 CENTREVILLE RD, STE J-15, HERNDON, VA 20171-4586
(703) 793-0291
(703) 793-0292
Mailing address
2465 CENTREVILLE RD, STE J-15, HERNDON, VA 20171-4586
(703) 793-0291
(703) 793-0292
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401412948
VA
Other
Enumeration date
01/07/2014
Last updated
01/07/2014
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