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General NPI Number Information
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NPI Number | 1972819043
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Entity Type | Individual
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Provider Name | ABDELROUF OTMAN SUWID B.D.S
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Gender | Male
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Dates
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Enumeration Date | 08/26/2010
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 8209 SUDLEY RD
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City | MANASSAS
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State | VA
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Zip | 20109-3507
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Country | US
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Telephone | 571-260-6222
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Fax | 703-938-2052
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Provider Business Mailing Address
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Address Line | 8209 SUDLEY RD
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City | MANASSAS
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State | VA
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Zip | 20109-3507
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Country | US
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Telephone | 571-260-6222
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Fax | 703-938-2052
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DL11050
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License Number State | VA
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