Individual
MARIE MICHELLE IMAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8605 WESTWOOD CENTER DR #200, VIENNA, VA 22182
(703) 942-8442
Mailing address
8605 WESTWOOD CENTER DR, #200, VIENNA, VA 22182
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401419098
VA
Other
Enumeration date
09/08/2023
Last updated
08/13/2024
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