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General NPI Number Information
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NPI Number | 1578641940
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Entity Type | Individual
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Provider Name | TAREK M ASHMAWY DDS,MSC,PHD
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 601 ROANOKE ST
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City | CHRISTIANSBURG
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State | VA
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Zip | 24073-3142
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Country | US
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Telephone | 164-625-0633
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Fax |
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Provider Business Mailing Address
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Address Line | 42761 LOCKLEAR TER
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City | CHANTILLY
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State | VA
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Zip | 20152-6634
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Country | US
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Telephone | 646-250-6333
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401411500
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License Number State | VA
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