# FAMILY DENTISTRY TOWN CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417128240
- **Authorized official:** DR. GWENDOLYN A. HOLLEY D.D.S. (PRESIDENT)
- **Authorized official phone:** (757) 497-3279

## Contact information

- **Practice address:** 310 HORACE AVE, VIRGINIA BEACH, VA 23462-2704
- **Practice address phone:** (757) 497-3279
- **Mailing address:** 310 HORACE AVE, VIRGINIA BEACH, VA 23462-2704
- **Mailing address phone:** (757) 497-3279

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401005542 | VA | Yes |

## Other

- **Enumeration date:** 03/19/2008
- **Last updated:** 03/19/2008