# COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Virginia Department of Health Division of Dental Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447588991
- **Authorized official:** DR. DAVID SUTTLE MD (DIRECTOR, OFFICE OF FAMILY HEALTH)
- **Authorized official phone:** (804) 864-7650

## Contact information

- **Practice address:** 109 GOVERNOR ST, RICHMOND, VA 23219-3623
- **Practice address phone:** (804) 864-7774
- **Mailing address:** 109 GOVERNOR ST RM 927, RICHMOND, VA 23219-3623
- **Mailing address phone:** (804) 864-7774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | VA | Yes |

## Other

- **Enumeration date:** 11/20/2009
- **Last updated:** 01/13/2010