Individual
MOHAMMED KASSIM ALMANDALAWI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
11921 MISTY COVE CT APT 103, HENRICO, VA 23233-7149
(909) 367-0755
Mailing address
821 S OAK PARK AVE, OAK PARK, IL 60304-1217
(909) 367-0755
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401413704
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019.031342
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/12/2012
Last updated
08/02/2018
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