Individual
SHAILENDRA DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
842 N SHENANDOAH AVE # 1, FRONT ROYAL, VA 22630-3543
(831) 869-2414
Mailing address
PO BOX 414, FRONT ROYAL, VA 22630-0009
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401414907
VA
1223G0001X
General Practice Dentistry
Primary
0401414907
VA
Other
Enumeration date
06/25/2015
Last updated
06/25/2015
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