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General NPI Number Information
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NPI Number | 1104062835
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Entity Type | Individual
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Provider Name | MOSTAFA SALAH EL DIN TOLBA DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 12/30/2008
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 556 GARRISONVILLE RD STE 200
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City | STAFFORD
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State | VA
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Zip | 22554-7826
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Country | US
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Telephone | 540-602-7889
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Fax | 540-584-8336
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Provider Business Mailing Address
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Address Line | 556 GARRISONVILLE RD STE 200
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City | STAFFORD
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State | VA
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Zip | 22554-7826
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Country | US
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Telephone | 540-602-7889
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Fax | 540-584-8336
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 0401412357
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License Number State | VA
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