Organization
BLOSSOM SMILE OF WOODBRIDGE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUSSEIN ALHASAN DDS, MSD (CEO)
(916) 622-2098
Entity
Organization
Contact information
Practice address
12618 LAKE RIDGE DR, WOODBRIDGE, VA 22192-2335
(916) 622-2098
Mailing address
6800 FLEETWOOD RD APT 1001, MC LEAN, VA 22101-3610
(916) 622-2098
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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