Organization
GDAT SHUKRANA PLLC
Active
Other names
Devena Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIVISPREET KAUR LUDHER DDS (DDS OWNER)
(703) 899-8523
Entity
Organization
Contact information
Practice address
10563 CRESTWOOD DR, MANASSAS, VA 20109-3406
(703) 899-8523
Mailing address
7658 CLIFTON RD, FAIRFAX STATION, VA 22039-2030
(703) 582-9611
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/22/2025
Last updated
05/22/2025
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