Individual
MADUEKE ETHELBERTH EKOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14634 LEE HIGHWAY, GAINESVILLE, VA 20155
(703) 753-4777
(703) 753-4677
Mailing address
14634 LEE HIGHWAY, GAINESVILLE, VA 20155
(703) 753-4777
(703) 753-4677
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401411793
VA
Other
Enumeration date
08/31/2007
Last updated
08/31/2007
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