Individual
DR. JUAN MANUEL CARRILLO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2008 JOHN ROLFE PARKWAY, RICHMOND, VA 23238
(804) 754-2020
(804) 754-2008
Mailing address
2008 JOHN ROLFE PARKWAY, RICHMOND, VA 23238
(804) 754-2020
(804) 754-2008
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401410612
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
186588
ANTHEM ID NUMBER
VA
Enumeration date
04/20/2006
Last updated
07/08/2007
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