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General NPI Number Information
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NPI Number | 1912165739
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Entity Type | Individual
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Provider Name | DYALA ABOUD DMD
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Gender | Female
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 07/18/2010
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Provider Practice Location Address
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Address Line | 1240 GASKINS RD
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City | RICHMOND
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State | VA
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Zip | 23238-5203
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Country | US
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Telephone | 412-427-6548
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Fax |
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Provider Business Mailing Address
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Address Line | 1240 GASKINS RD
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City | RICHMOND
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State | VA
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Zip | 23238-5203
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Country | US
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Telephone | 412-427-6548
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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 | 0401412791
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License Number State | VA
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