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Individual

DR. IRA M ROSENTHAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
9661 MAIN ST, SUITE C, FAIRFAX, VA 22031-3757
(703) 425-3737
(703) 425-3762
Mailing address
9661 MAIN ST, SUITE C, FAIRFAX, VA 22031-3757
(703) 425-3737
(703) 425-3762

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0401007625
VA

Other

Enumeration date
04/26/2007
Last updated
07/08/2007
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