Organization
IDEAL SMILE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR ABUHAJLEH (DOCTOR/DENTIST)
(804) 918-9667
Entity
Organization
Contact information
Practice address
8904 W BROAD ST, RICHMOND, VA 23294-5826
(804) 918-9667
Mailing address
8904 W BROAD ST, RICHMOND, VA 23294-5826
(804) 918-9667
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401412655
VA
Other
Enumeration date
11/10/2017
Last updated
11/10/2017
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