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Individual

DALIAH BAZERBASHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
4023 ROYAL LYTHAM DR, FAIRFAX, VA 22033-2016
(301) 921-6073
Mailing address
4023 ROYAL LYTHAM DR, FAIRFAX, VA 22033-2016
(301) 921-6073

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401417685
VA

Other

Enumeration date
09/13/2021
Last updated
09/13/2021
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