Individual
SHERRY L BASHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3166 GOLANSKY BLVD, WOODBRIDGE, VA 22192-4263
(703) 730-2931
Mailing address
15619 RHAME DR, DUMFRIES, VA 22025-1107
(703) 878-7637
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
0402203521
VA
Other
Enumeration date
09/04/2021
Last updated
09/04/2021
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