Individual
PRIYANKA DUTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
5002 AIRPORT RD NW # 30, ROANOKE, VA 24012-1607
(888) 344-3613
Mailing address
16 OLD WOODS AVE, APT 206, ROANOKE, VA 24016-1422
(562) 595-2862
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401414733
VA
1223G0001X
General Practice Dentistry
DN 20684
FL
Other
Enumeration date
06/10/2014
Last updated
06/16/2015
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