Provider Demographics
NPI:1437304649
Name:MESSINA CANAL MOAWAD DDS PC
Entity Type:Organization
Organization Name:MESSINA CANAL MOAWAD DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CANAL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-318-8200
Mailing Address - Street 1:1886 METRO CENTER DRIVE SUITE 600
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190
Mailing Address - Country:US
Mailing Address - Phone:703-318-8200
Mailing Address - Fax:703-318-0834
Practice Address - Street 1:1886 METRO CENTER DRIVE SUITE 600
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190
Practice Address - Country:US
Practice Address - Phone:703-318-8200
Practice Address - Fax:703-318-0834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-02
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty