Individual
AWS ALTAMEEMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
392 GARRISONVILLE ROAD 205, STAFFORD, VA 22554
(240) 200-4006
Mailing address
14701 RIVER WALK WAY APT 396, WOODBRIDGE, VA 22191
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401416174
VA
Other
Enumeration date
09/02/2018
Last updated
09/02/2018
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