Individual
MUAZZAM FAROOQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12423 EDEN LN, WOODBRIDGE, VA 22192-6337
(703) 608-2209
Mailing address
12423 EDEN LN, WOODBRIDGE, VA 22192-6337
(703) 608-2209
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401416512
VA
Other
Enumeration date
04/24/2019
Last updated
05/31/2019
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