# VIRGINIA COMMONWEALTH UNIVERSITY

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

## Provider details

- **NPI number:** 1932327277
- **Authorized official:** DR. BETSY ANN HAGAN DDS, MBA (SENIOR ASSOCIATE DEAN)
- **Authorized official phone:** (804) 828-7978

## Contact information

- **Practice address:** 520 N 12TH ST, LYONS BUILDING, ROOM 456, RICHMOND, VA 23298-0566
- **Practice address phone:** (804) 828-7978
- **Mailing address:** 520 N 12TH ST, LYONS BUILDING, ROOM 456, P.O. BOX 980566, RICHMOND, VA 23298-0566
- **Mailing address phone:** (804) 828-7978

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 0401005311 | VA | Yes |

## Other

- **Enumeration date:** 04/23/2007
- **Last updated:** 08/22/2020