Organization
BLOOM DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHKAN YOUSEFI DDS (OWNER)
(408) 888-9240
Entity
Organization
Contact information
Practice address
900 N RANDOLPH ST STE 103, ARLINGTON, VA 22203-1949
(703) 243-3600
Mailing address
900 N RANDOLPH ST STE 103, ARLINGTON, VA 22203-1949
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401413246
VA
1223G0001X
General Practice Dentistry
0401415049
VA
Other
Enumeration date
07/12/2017
Last updated
07/12/2017
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