Individual
JOSEMARI DELEON IMAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
159 LICHFIELD BLVD, SUITE 107, FREDERICKSBURG, VA 22406
(540) 373-2273
(540) 373-9233
Mailing address
159 LICHFIELD BLVD, SUITE 107, FREDERICKSBURG, VA 22406-8427
(540) 373-2273
(540) 373-9233
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401412284
VA
Other
Enumeration date
11/17/2008
Last updated
11/17/2008
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