Organization
ROXANNE AZMOUDEH, D.D.S. P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROXANNE AZMOUDEH DDS (PRESIDENT)
(703) 858-9146
Entity
Organization
Contact information
Practice address
44355 PREMIER PLZ STE 100, ASHBURN, VA 20147-5050
(703) 858-9146
(703) 858-9147
Mailing address
44355 PREMIER PLZ STE 100, ASHBURN, VA 20147-5050
(703) 858-9146
(703) 858-9147
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0401410979
VA
Other
Enumeration date
06/26/2018
Last updated
06/26/2018
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