Individual
DR. OSAMA SHOUEB MODJADIDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
113 GAINSBOROUGH SQ, SUITE 101, CHESAPEAKE, VA 23320-1713
(757) 548-5619
(757) 548-6930
Mailing address
113 GAINSBOROUGH SQ, SUITE 101, CHESAPEAKE, VA 23320-1713
(757) 548-5619
(757) 548-6930
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10783
VA
Other
Enumeration date
08/01/2008
Last updated
10/10/2012
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