Healthcare Provider Details
I. General information
NPI: 1093326084
Provider Name (Legal Business Name): COMFY DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/12/2020
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
915 N QUINCY ST
ARLINGTON VA
22203-1907
US
IV. Provider business mailing address
915 N QUINCY ST
ARLINGTON VA
22203-1907
US
V. Phone/Fax
- Phone: 703-276-1010
- Fax:
- Phone: 703-276-1010
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0300X |
| Taxonomy | Periodontics |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
OMER
AKMAL
Title or Position: PARTNER
Credential: DDS
Phone: 202-277-6444