Individual
KAMBIZ TAVAKKOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
1500 KING ST, SUITE 300, ALEXANDRIA, VA 22314-2730
(703) 683-6688
(703) 683-6690
Mailing address
1500 KING ST, SUITE 300, ALEXANDRIA, VA 22314-2730
(703) 683-6688
(703) 683-6690
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10837
VA
Other
Enumeration date
10/25/2010
Last updated
10/25/2010
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