Organization
EAST BEACH SMILES LLC
Active
Other names
East Beach Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MOSTAFA ABOULKHAIR D.M.D (OWNER/DENTIST)
(757) 362-0600
Entity
Organization
Contact information
Practice address
4520 PRETTY LAKE AVE, #201, NORFOLK, VA 23518
(757) 362-0600
(757) 362-0010
Mailing address
4520 PRETTY LAKE AVE, #201, NORFOLK, VA 23518
(757) 362-0600
(757) 362-0010
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401411899
VA
Other
Enumeration date
07/19/2018
Last updated
07/19/2018
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