Individual
DR. TABASOM SANJIDEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MMS
Contact information
Practice address
10051 MARKET CIR, MANASSAS, VA 20110-2120
(703) 214-2619
Mailing address
21759 GADWALL SQUARE, #F, ASHBURN, VA 20147
(571) 437-4409
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401419047
VA
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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