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Organization

ALL PRO DENTAL CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MAI KOUSSA DDS (DENTIST)
(703) 663-8276
Entity
Organization

Contact information

Practice address
8500 EXECUTIVE PARK AVE, SUITE 208, FAIRFAX, VA 22031-2225
(703) 663-8276
Mailing address
8500 EXECUTIVE PARK AVE, SUITE 208, FAIRFAX, VA 22031-2225
(703) 663-8276

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
0401410151
VA

Other

Enumeration date
11/08/2013
Last updated
11/08/2013
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