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Individual

FAHD YOUSAF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
6509 DIVINE ST, MC LEAN, VA 22101-4620
(703) 589-2599
Mailing address
6509 DIVINE ST, MC LEAN, VA 22101-4620

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401414536
VA
390200000X
Student in an Organized Health Care Education/Training Program
NY

Other

Enumeration date
03/10/2014
Last updated
07/07/2014
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