Individual
DR. JEENA ELIZABETH DEVASIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
6707 OLD DOMINION DR, SUITE 240, MC LEAN, VA 22101-4504
(703) 734-2750
Mailing address
6455 OLD CHESTERBROOK RD, MC LEAN, VA 22101-4741
(703) 356-9264
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401414849
VA
Other
Enumeration date
06/05/2015
Last updated
06/05/2015
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