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Organization
LUCY CORR FOUNDATION, INC.
Active
Organization
LUCY CORR FOUNDATION, INC.
Active
Other names
Lucy Corr Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMMY HOLBERT SHACKELFORD (EXECUTIVE DIRECTOR)
(804) 467-2255
Entity
Organization
Contact information
Practice address
6800 LUCY CORR BLVD., CHESTERFIELD, VA 23832-6657
(804) 467-2255
Mailing address
6800 LUCY CORR BLVD., CHESTERFIELD, VA 23832-6657
(804) 467-2255
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
NULL
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Enumeration date
06/23/2021
Last updated
07/01/2021
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