Individual
DR. MAXWELL F MARZOUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4322 RAVENSWORTH RD, ANNANDALE, VA 22003-5630
(703) 940-1359
Mailing address
3614 LAMPLIGHT DR, FAIRFAX, VA 22033-1730
(703) 424-6534
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401416994
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/04/2019
Last updated
08/24/2020
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