Individual
DR. HALA ELHAM IMAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1976 CRESCENT PARK DR, RESTON, VA 20190-3288
(703) 867-7920
Mailing address
1976 CRESCENT PARK DR, RESTON, VA 20190-3288
(703) 867-7920
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401416073
VA
1223G0001X
General Practice Dentistry
Primary
0401416073
VA
Other
Enumeration date
06/18/2018
Last updated
06/18/2018
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