Organization
KANAKA SRIRAM, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KANAKA SRIRAM D.D.S. (DENTIST)
(703) 255-2326
Entity
Organization
Contact information
Practice address
410 MAPLE AVE W, SUITE 2, VIENNA, VA 22180-4240
(703) 255-2326
Mailing address
410 MAPLE AVE W, SUITE 2, VIENNA, VA 22180-4240
(703) 255-2326
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401007621
VA
Other
Enumeration date
05/06/2007
Last updated
08/22/2020
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