South Riding Oral and Implant Surgery

NPI #1285296814 in Chantilly, Virginia

Provider Information

NPI Number: 1285296814
Entity Type: Organization
Organization Name: South Riding Oral and Implant Surgery
Primary Specialty: Dentist - Oral and Maxillofacial Surgery
Enumeration Date: Jul 3, 2019
Last Updated: Jul 3, 2019

Practice Location

Address: 24805 PINEBROOK RD # 318
City: Chantilly
State: Virginia
ZIP Code: 20152-4126
Phone: (571) 218-0878

Authorized Official

Name: DR. KAMRAN RAJA, DMD, MD
Title: OWNER
Phone: (571) 218-0878

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X	Primary

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