Organization
MITRA HOOSHANGI DDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITRA HOOSHANGI (DENTIST)
(703) 893-7900
Entity
Organization
Contact information
Practice address
2112 GALLOWS RD # D, VIENNA, VA 22182-3963
(703) 893-7900
Mailing address
2112 GALLOWS RD # D, VIENNA, VA 22182-3963
(703) 893-7900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401007850
VA
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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