Individual
DR. TESFAYE HAILEMARIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
85 S BRAGG ST, SUITE 300, ALEXANDRIA, VA 22312-2797
(703) 256-7711
(703) 256-6226
Mailing address
PO BOX 141, BURKE, VA 22009-0141
(703) 256-7711
(703) 256-6226
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401410490
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104989
—
VA
Enumeration date
08/11/2006
Last updated
07/09/2007
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