Individual
JILA TAHMASEBI-BOLDAJI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8212 OLD COURTHOUSE RD, VIENNA, VA 22182-3821
(240) 731-3768
(703) 448-0602
Mailing address
8212 OLD COURTHOUSE RD, VIENNA, VA 22182-3821
(240) 731-3768
(703) 448-0602
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401412302
VA
Other
Enumeration date
11/27/2008
Last updated
11/27/2008
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