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1194450551
MAHSASADAT MORTAZAVI
BURKE, VA
NPI
1194450551
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: VA 0401417746)
Enumeration Date
2022-07-20
Last Update Date
2022-07-20
Business Address
MAHSASADAT MORTAZAVI
6505 SYDENSTRICKER RD STE B
BURKE, VA 22015-4282
Phone number: 703-691-5343
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Mailing Address
MAHSASADAT MORTAZAVI
1747 TYSONS CENTRAL ST APT 2407
VIENNA, VA 22182-6058
Phone number: 510-333-1711
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