Individual
GABRIELLA C BASHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
131 ELDEN ST STE 130, HERNDON, VA 20170-4835
(703) 689-3900
Mailing address
9002 LUPINE DEN DR, VIENNA, VA 22182-2163
(202) 468-1641
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401416721
VA
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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