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Individual

LOUIS BWANA KALOMBO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
5473 ANNE LY LN, ALEXANDRIA, VA 22310-1878
(703) 282-8347
Mailing address
5473 ANNE LY LANE, ALEXANDRIA, ALEXANDRIA, VA 22310
(703) 282-8347

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
0401414224
VA
122300000X
Dentist
Primary
DEN1001312
DC

Other

Enumeration date
10/28/2013
Last updated
10/28/2013
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