Provider Demographics
NPI:1417521055
Name:ROYAL DENTAL PLLC
Entity Type:Organization
Organization Name:ROYAL DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABOUEL ENIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-361-2345
Mailing Address - Street 1:9940 SOWDER VILLAGE SQ
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-5464
Mailing Address - Country:US
Mailing Address - Phone:703-361-2345
Mailing Address - Fax:703-656-4861
Practice Address - Street 1:9940 SOWDER VILLAGE SQ
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-5464
Practice Address - Country:US
Practice Address - Phone:703-361-2345
Practice Address - Fax:703-656-4861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental