Organization
NORTHUMBERLAND COUNTY DENTAL CLINIC
Active
Parent organization
THREE RIVERS HEALTH DISTRICT
Other names
THREE RIVERS HEALTH DISTRICT
Organization subpart
Yes
Provider details
NPI number
Legal business name
THREE RIVERS HEALTH DISTRICT
Authorized official
DR. DANIEL LAWRENCE DDS (HEALTH DEPT DENTIST)
(804) 758-2381
Entity
Organization
Contact information
Practice address
6373 NORTHUMBERLAND HWY - SUITE B, HEATHSVILLE, VA 22473
(804) 758-2381
(804) 758-4828
Mailing address
6373 NORTHUMBERLAND HWY - SUITE B, P O BOX 69, HEATHSVILLE, VA 22473
(804) 758-2381
(804) 758-4828
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
0401004548
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106879
DORAL (VA SMILES)
VA
05
—
8451176
—
VA
Enumeration date
08/31/2006
Last updated
07/09/2008
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