Individual
MAHA M ABOUEL ENIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14228 SMOKETOWN RD, WOODBRIDGE, VA 22192-4708
(703) 793-2006
Mailing address
14228 SMOKETOWN RD, WOODBRIDGE, VA 22192-4708
(703) 794-2006
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401416371
VA
1223G0001X
General Practice Dentistry
Primary
0401416371
VA
Other
Enumeration date
02/28/2019
Last updated
03/18/2019
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