| Empire Dental | |
|
5622 Columbia Pike Suite 103 Falls Church VA 22041-2718 | |
| (703) 575-8789 | |
| Not Available |
| Full Name | Empire Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5622 Columbia Pike, Falls Church, Virginia |
| Authorized Official Name and Position | Mulualem Tesfaye Assefa (OWNER) |
| Authorized Official Contact | 7035758789 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Empire Dental 5622 Columbia Pike Suite 103 Falls Church VA 22041-2718 Ph: (703) 575-8789 | Empire Dental 5622 Columbia Pike Suite 103 Falls Church VA 22041-2718 Ph: (703) 575-8789 |
| NPI Number | 1639629744 |
|---|---|
| Provider Enumeration Date | 10/12/2016 |
| Last Update Date | 10/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639629744 | NPI | - | NPPES |
| 1053793653 | Other | NPI TYPE 2 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401415215 (Virginia) | Primary |
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