Individual
DR. AICHA LYAZIDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1392 OLD BRIDGE RD, WOODBRIDGE, VA 22192-2708
(703) 490-9094
Mailing address
1392 OLD BRIDGE RD, WOODBRIDGE, VA 22192-2708
(703) 490-9094
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401410695
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9179052
—
VA
Enumeration date
10/17/2006
Last updated
03/19/2014
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