Individual
ANDREW LOREN BETAHARON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8400 KAY CT, ANNANDALE, VA 22003-2206
(240) 338-5995
Mailing address
8400 KAY CT, ANNANDALE, VA 22003-2206
(240) 338-5995
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401412823
VA
1223G0001X
General Practice Dentistry
Primary
14644
MD
Other
Enumeration date
06/30/2009
Last updated
03/18/2016
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