# UPPER MATTAPONI INDIAN TRIBE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** UPPER MATTAPONI INDIAN TRIBE
- **Other names:** Aylett Family Dentistry
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1245098391
- **Legal business name:** UPPER MATTAPONI INDIAN TRIBE
- **Authorized official:** STEVEN TUPPONCE (DIRECTOR-UMIT HEALTH SERVICES)
- **Authorized official phone:** (804) 347-4109

## Contact information

- **Practice address:** 8014 RICHMOND TAPPAHANNOCK HWY, AYLETT, VA 23009-3056
- **Practice address phone:** (804) 769-2015
- **Mailing address:** 13476 KING WILLIAM RD, KING WILLIAM, VA 23086-3401
- **Mailing address phone:** (804) 769-0041

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | — |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223P0221X | Pediatric Dentistry | — | NULL | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/12/2024
- **Last updated:** 06/27/2024