Individual
SARA RAJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6954 JEREMIAH CT, MANASSAS, VA 20111-4392
(571) 594-1631
Mailing address
6954 JEREMIAH CT, MANASSAS, VA 20111-4392
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
058840
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2015
Last updated
10/12/2016
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