Individual
DR. SUPRAJA BILAKANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
400C SOUTHPARK BLVD, COLONIAL HEIGHTS, VA 23834-2974
(800) 904-5665
(678) 904-5666
Mailing address
400 GALLERIA PKWY SE, SUITE 800, ATLANTA, GA 30339-5980
(770) 916-5352
(678) 247-7862
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401412574
VA
Other
Enumeration date
01/09/2010
Last updated
01/09/2010
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