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Organization
VIRGINIA COMMONWEALTH UNIVERSITY
Active
Organization
VIRGINIA COMMONWEALTH UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALFRED JOSEPH CERTOSIMO DMD (CHAIR, DEPT. OF GENERAL PRACTICE)
(804) 828-2977
Entity
Organization
Contact information
Practice address
520 N 12TH STREET, LYONS BLDG ROOM 414, RICHMOND, VA 23298-0566
(804) 828-2977
(804) 828-3159
Mailing address
520 N 12TH STREET, LYONS BLDG ROOM 414, RICHMOND, VA 23298-0566
(804) 828-2977
(804) 828-3159
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0401008264
VA
Other
Enumeration date
04/30/2008
Last updated
04/30/2008
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