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General NPI Number Information
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NPI Number | 1003430851
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Entity Type | Individual
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Provider Name | HAMZAH ALGHAZALI DDS
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Gender | Male
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Dates
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Enumeration Date | 06/07/2020
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Last Update Date | 06/07/2020
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Provider Practice Location Address
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Address Line | 8310 OLD COURTHOUSE RD STE A
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City | TYSONS
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State | VA
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Zip | 22182-3872
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Country | US
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Telephone | 703-828-0613
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Fax |
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Provider Business Mailing Address
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Address Line | 10864 MONTICELLO CT
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City | GREAT FALLS
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State | VA
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Zip | 22066-4239
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Country | US
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Telephone | 773-754-9261
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401416868
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License Number State | VA
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