SHANE RYAN COSTA

RESTON, VA
NPI1407889306
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: VA  0401410911)
Enumeration Date2006-07-07
Last Update Date2007-07-08
Business Address
Dr. SHANE RYAN COSTA D.D.S
1950 ROLAND CLARKE PL SUITE 450
RESTON, VA 20191-1414
Phone number: 703-391-2600
Mailing Address
Dr. SHANE RYAN COSTA D.D.S
1626 APRICOT CT
RESTON, VA 20190-4404
Phone number: 703-956-9097
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