# DENTAL PROFESSIONALS OF VIRGINIA, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DENTAL PROFESSIONALS OF VIRGINIA, P.C.
- **Other names:** LWSS FAMILY DENTISTRY - SUFFOLK
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1053077453
- **Legal business name:** DENTAL PROFESSIONALS OF VIRGINIA, P.C.
- **Authorized official:** HILLARY THULL (CREDENTIALING COORDIANTOR)
- **Authorized official phone:** (217) 540-8946

## Contact information

- **Practice address:** 210 MEADOW VIEW BLVD, SUFFOLK, VA 23435-3495
- **Practice address phone:** (757) 416-5977
- **Mailing address:** 210 MEADOW VIEW BLVD, SUFFOLK, VA 23435-3495

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 11/10/2021
- **Last updated:** 11/17/2021