Individual
JAYAMOLE ZACHARIAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21406 ASHBURN RUN PL, ASHBURN, VA 20147-5347
(240) 338-2052
Mailing address
21406 ASHBURN RUN PL, ASHBURN, VA 20147-5347
(240) 338-2052
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401414633
VA
Other
Enumeration date
07/14/2015
Last updated
07/14/2015
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