| NPI | 1053145508 |
|---|---|
| Doing Business As | LOUDOUN INNOVATIVE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ABDULLAH MAHGOUB Owner 281-467-3397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-08-28 |
| Last Update Date | 2024-08-28 |