Individual
DIVYA KANODIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13880 BRADDOCK RD STE 307, CENTREVILLE, VA 20121-2462
(703) 815-3636
Mailing address
733 15TH ST NW APT 216, WASHINGTON, DC 20005-2136
(617) 230-2904
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
0401417622
VA
Other
Enumeration date
08/11/2021
Last updated
08/11/2021
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