Individual
DR. HAROLD HARVEY FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4660 KENMORE AVE, SUITE 300, ALEXANDRIA, VA 22304-1313
(703) 823-2422
(703) 842-8671
Mailing address
4660 KENMORE AVE, SUITE 300, ALEXANDRIA, VA 22304-1313
(703) 823-2422
(703) 842-8671
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0401004958
VA
Other
Enumeration date
01/31/2007
Last updated
08/04/2008
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