Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
Other names
Spotsylvania Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JANE KRAKOWSKY (BUSINESS MANAGER)
(540) 899-4797
Entity
Organization
Contact information
Practice address
9104 COURTHOUSE RD, SPOTSYLVANIA, VA 22553-1902
(540) 582-7350
Mailing address
608 JACKSON ST, FREDERICKSBURG, VA 22401-5719
(540) 899-4797
(540) 899-4599
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104797
DORAL
VA
01
—
142978
ANTHEM-COLE
VA
01
—
144860
ANTHEM-MILLER
VA
Enumeration date
08/11/2006
Last updated
08/25/2008
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