Individual
DR. AMIN NEISHABOORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7911 WESTPARK DR APT 1915, MC LEAN, VA 22102-4296
(646) 648-2528
Mailing address
7911 WESTPARK DR APT 1915, MC LEAN, VA 22102-4296
(646) 648-2528
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401417435
VA
Other
Enumeration date
06/29/2022
Last updated
12/12/2022
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