Organization
GOOD HOPE FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREJE LEGESSE BEREDED DDS (OWNER)
(202) 581-7600
Entity
Organization
Contact information
Practice address
2645 NAYLOR RD SE STE 102, WASHINGTON, DC 20020-7255
(202) 581-7600
Mailing address
PO BOX 4129, ARLINGTON, VA 22204-0129
(202) 581-7600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN1000305
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034492500
—
DC
Enumeration date
03/24/2008
Last updated
03/24/2008
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