Individual
DR. MINA T MOSTOFI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
12724 DIRECTORS LOOP, LAKE RIDGE, VA 22192-2462
(703) 494-9171
(703) 490-4066
Mailing address
12724 DIRECTORS LOOP, LAKE RIDGE, VA 22192-2462
(703) 494-9171
(703) 490-4066
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401007810
VA
Other
Enumeration date
12/20/2007
Last updated
12/20/2007
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