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2757 Jefferson Davis Hwy Suite 119 Stafford VA 22554-8327 | |
| (540) 659-2000 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 2757 Jefferson Davis Hwy, Stafford, Virginia |
| Authorized Official Name and Position | Raj Patel (DENTIST) |
| Authorized Official Contact | 5406592000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2757 Jefferson Davis Hwy Suite 119 Stafford VA 22554-8327 Ph: (540) 659-2000 | 2757 Jefferson Davis Hwy Suite 119 Stafford VA 22554-8327 Ph: (540) 659-2000 |
| NPI Number | 1063422657 |
|---|---|
| Provider Enumeration Date | 08/08/2006 |
| Last Update Date | 05/26/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063422657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | VA7938 (Virginia) | Primary |
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