Individual
INDRA Z MUSTAPHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDA, MS, PHD
Contact information
Practice address
1221 MASSACHUSETTS AVE NW, WASHINGTON, DC 20005-5302
(202) 628-7979
Mailing address
1221 MASSACHUSETTS AVE NW, WASHINGTON, DC 20005-5302
(202) 628-7979
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN5830
DC
1223P0300X
Periodontics
12138
MD
Other
Enumeration date
12/31/2008
Last updated
07/08/2015
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