Individual
MS. HIYAB YOHANNES WOLDESELASIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 289-4646
Mailing address
246 CATALINA BLVD, SAN RAFAEL, CA 94901-4480
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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