Organization
SURYA P DHAKAR DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SURYA P DHAKAR DDS (DENTIST)
(804) 217-9820
Entity
Organization
Contact information
Practice address
4440 SPRINGFIELD RD, #101, GLEN ALLEN, VA 23060-3410
(804) 217-9820
(804) 217-9822
Mailing address
4440 SPRINGFIELD RD, #101, GLEN ALLEN, VA 23060-3410
(804) 217-9820
(804) 217-9822
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
00410078
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2107285
MAMSI
—
01
—
432116
ANTHEM
VA
01
—
817248
UNITED CONCORDIA
—
Enumeration date
11/09/2005
Last updated
08/22/2020
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