# MARYBETH WICKER, DDS, PC

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

## Provider details

- **NPI number:** 1750538203
- **Authorized official:** DR. MARYBETH WICKER (PRESIDENT)
- **Authorized official phone:** (804) 320-3200

## Contact information

- **Practice address:** 9017 FOREST HILL AVE, RICHMOND, VA 23235-3051
- **Practice address phone:** (804) 320-3200
- **Mailing address:** 9017 FOREST HILL AVE, RICHMOND, VA 23235-3051
- **Mailing address phone:** (804) 320-3200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 0401410286 | VA | Yes |

## Other

- **Enumeration date:** 08/26/2008
- **Last updated:** 08/26/2008