Individual
SHIVAPRASANNA RAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
239 GARRISONVILLE RD, 102, STAFFORD, VA 22554-1554
(540) 657-0867
Mailing address
239 GARRISONVILLE RD, 102, STAFFORD, VA 22554-1554
(540) 657-0867
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401007933
VA
Other
Enumeration date
09/02/2006
Last updated
07/08/2007
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