Individual
BIJAN M KOOSHKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
44345 PREMIER PLAZA, SUITE 220, ASHBURN, VA 20147
(703) 729-9666
(703) 729-4722
Mailing address
1444 KEMPSVILLE RD 101, VIRGINIA BEACH, VA 23464-7302
(757) 497-8611
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0401008844
VA
Other
Enumeration date
01/30/2007
Last updated
11/21/2015
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