Individual
MUSTAFA SHAGHATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
25654 CABIN POINT CT, CHANTILLY, VA 20152-5700
(202) 808-1252
Mailing address
25654 CABIN POINT CT, CHANTILLY, VA 20152-5700
(202) 808-1252
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401418473
VA
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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