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Organization

AILIN SHAN,DMD,PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. AILIN SHAN DMD (PRESIDENT)
(804) 756-6658
Entity
Organization

Contact information

Practice address
5412 GLENSIDE DR, SUITE C, RICHMOND, VA 23228-3995
(804) 756-6658
(804) 756-6662
Mailing address
5412 GLENSIDE DR, SUITE C, RICHMOND, VA 23228-3995
(804) 756-6658
(804) 756-6662

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9180406
VA
Enumeration date
03/10/2008
Last updated
03/10/2008
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