Individual
PADMAJA YALAMANCHILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
10875 MAIN ST STE 103, FAIRFAX, VA 22030-4732
(703) 591-4010
Mailing address
10875 MAIN ST STE 103, FAIRFAX, VA 22030-4732
(703) 591-4010
(703) 580-0358
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411072
VA
Other
Enumeration date
11/28/2006
Last updated
02/24/2020
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