Individual
SHIVANGI B AMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2420 OLD BRICK RD APT 1315, GLEN ALLEN, VA 23060-5995
(408) 466-5157
Mailing address
2801 MCRAE RD STE C1, NORTH CHESTERFIELD, VA 23235-3056
(804) 272-9079
(804) 272-9107
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0401415876
VA
Other
Enumeration date
07/31/2018
Last updated
10/29/2018
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