Organization
FAIRFAX PERIODONTAL AND IMPLANT CENTER, PLLC
Active
Other names
Woodbridge Periodontal and Implant Center
Organization subpart
No
Provider details
NPI number
Authorized official
AHMAD HAWASLI DDS (OWNER/DENTIST)
(703) 491-2974
Entity
Organization
Contact information
Practice address
8622 ROUTE 29 STE D, FAIRFAX, VA 22031-2148
(703) 491-2974
Mailing address
8622 ROUTE 29 STE D, FAIRFAX, VA 22031-2148
(703) 491-2974
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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