Individual
DR. ELBETHEL DEREJE DEFARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1910 THOMSON DR, LYNCHBURG, VA 24501-1009
(434) 847-4581
Mailing address
43154 ASHLEY GREEN DR, ASHBURN, VA 20148-7045
(540) 326-1711
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401419020
VA
Other
Enumeration date
06/12/2024
Last updated
07/26/2024
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