# HENDRICK B. TAFO-TABUE, DDS, PC

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

## Provider details

- **NPI number:** 1922408194
- **Authorized official:** DR. HENDRICK BASTIAAN TAFO-TABUE DDS (OWNER)
- **Authorized official phone:** (832) 713-2497

## Contact information

- **Practice address:** 12201 TIVERTON LN, GLEN ALLEN, VA 23059-7015
- **Practice address phone:** (832) 713-2497
- **Mailing address:** 12201 TIVERTON LN, GLEN ALLEN, VA 23059-7015
- **Mailing address phone:** (832) 713-2497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401413401 | VA | Yes |

## Other

- **Enumeration date:** 08/25/2014
- **Last updated:** 08/25/2014