Provider Demographics
NPI:1689286254
Name:DOLIA, RAJDEEPSINH NARENDRASINH (DMD)
Entity Type:Individual
Prefix:
First Name:RAJDEEPSINH
Middle Name:NARENDRASINH
Last Name:DOLIA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 TOWN MADISON BLVD APT 3209
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-6692
Mailing Address - Country:US
Mailing Address - Phone:601-462-8433
Mailing Address - Fax:
Practice Address - Street 1:12205 COUNTY LINE RD STE A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-7720
Practice Address - Country:US
Practice Address - Phone:256-772-9988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD.0006801-C1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist