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Organization

DYNAMIC DENTAL PC

Active
Other names
Dynamic Family Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
FARIDA G KHATTAK DDS (OWNER/DENTIST)
(703) 531-0010
Entity
Organization

Contact information

Practice address
159 HILLWOOD AVE, FALLS CHURCH, VA 22046-2913
(703) 531-0010
(703) 531-1330
Mailing address
159 HILLWOOD AVE, FALLS CHURCH, VA 22046-2913
(703) 531-0010
(703) 531-1330

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401412386
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1841430873
NPI
VA
Enumeration date
07/22/2011
Last updated
07/22/2011
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