Provider Demographics
NPI:1689146334
Name:RADWA M SOBIEH DDS PLLC
Entity Type:Organization
Organization Name:RADWA M SOBIEH DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RADWA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBIEH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:763-269-9944
Mailing Address - Street 1:650 CEDAR CREEK GRADE STE 205
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6454
Mailing Address - Country:US
Mailing Address - Phone:540-323-7063
Mailing Address - Fax:540-860-7007
Practice Address - Street 1:650 CEDAR CREEK GRADE STE 205
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6454
Practice Address - Country:US
Practice Address - Phone:540-323-7063
Practice Address - Fax:540-860-7007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental