Individual
DR. MOHAMAD BASHAR AYASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
14631 LEE HWY, #301, CENTREVILLE, VA 20121
(703) 830-2256
Mailing address
14631 LEE HWY, #301, CENTREVILLE, VA 20121-5824
(703) 830-2256
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411737
VA
Other
Enumeration date
10/31/2011
Last updated
10/31/2011
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