Individual
DR. IDA KONDORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3925 OLD LEE HWY STE 51C, FAIRFAX, VA 22030-2426
(703) 919-0559
Mailing address
2920 FOX MILL MANOR DR, OAKTON, VA 22124-1246
(703) 662-1432
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401413361
VA
Other
Enumeration date
10/30/2011
Last updated
09/05/2020
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