Organization
ELITE DENTAL CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHALID MANSOUR HUSSEIN DDS (PRESIDENT)
(703) 661-6380
Entity
Organization
Contact information
Practice address
23520 OVERLAND DR, SUITE 134, DULLES, VA 20166-2196
(703) 661-6380
Mailing address
23520 OVERLAND DR, SUITE 134, DULLES, VA 20166-2196
(703) 661-6380
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411564
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9180007
—
VA
Enumeration date
03/10/2008
Last updated
03/10/2008
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