Individual
MANHAL ELILIWI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6564 LOISDALE CT STE 110, SPRINGFIELD, VA 22150-1822
(703) 719-5828
Mailing address
12752 CEDAR RD, CLEVELAND HEIGHTS, OH 44106-3366
(216) 534-0914
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401417311
VA
Other
Enumeration date
08/03/2016
Last updated
03/12/2021
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