Individual
ILIANA TATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
900 GARDENS BLVD, SUITE 600, CHARLOTTESVILLE, VA 22901-1469
(434) 984-3455
Mailing address
71 D BARCLAY PL. CT., CHARLOTTESVILLE, VA 22901
(434) 293-8511
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401411825
VA
Other
Enumeration date
07/03/2007
Last updated
07/08/2007
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