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General NPI Number Information
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NPI Number | 1841697356
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Entity Type | Individual
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Provider Name | ALY ELGEDDAWI D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/26/2014
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | 8303 ARLINGTON BLVD. SUITE #104
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City | FAIRFAX
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State | VA
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Zip | 22031
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Country | US
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Telephone | 703-207-0700
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Fax | 571-419-6923
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Provider Business Mailing Address
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Address Line | 8303 ARLINGTON BLVD. SUITE #104
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City | FAIRFAX
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State | VA
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Zip | 22031
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Country | US
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Telephone | 703-207-0700
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Fax | 571-419-6923
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401414896
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License Number State | VA
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