Individual
DR. TIBEBU MEKONNEN TSEGGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236
(615) 668-3322
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(615) 668-3322
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
8585
TN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
28366
TX
Other
Enumeration date
10/18/2006
Last updated
06/01/2018
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