| Loudoun Innovative Dentistry | |
|
24305 Liberty Harvest Ct Ste 110 Sterling VA 20166-3422 | |
| (703) 775-1110 | |
| Not Available |
| Full Name | Loudoun Innovative Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 24305 Liberty Harvest Ct Ste 110, Sterling, Virginia |
| Authorized Official Name and Position | Abdullah Mahgoub (OWNER) |
| Authorized Official Contact | 2814673397 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Loudoun Innovative Dentistry 24305 Liberty Harvest Ct Ste 110 Sterling VA 20166-3422 | Loudoun Innovative Dentistry 24305 Liberty Harvest Ct Ste 110 Sterling VA 20166-3422 Ph: (703) 775-1110 |
| NPI Number | 1053145508 |
|---|---|
| Provider Enumeration Date | 08/28/2024 |
| Last Update Date | 08/28/2024 |
| Certification Date | 08/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053145508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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