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Individual

AILIN SHAN

Active
Sole proprietor

Provider details

NPI number
Gender
F

Contact information

Practice address
5322 CHAMBERLAYNE AVE, RICHMOND, VA 23227-2203
(804) 266-5040
Mailing address
415 N GRAND AVE, PUEBLO, CO 81003-3111
(719) 546-3333

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401410938
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9180406
DORAL
VA
Enumeration date
03/05/2006
Last updated
07/08/2007
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