Individual
ADWOA BOATENG BAIDOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4100 QUARLES CT, ROCKINGHAM, VA 22801-8797
(703) 206-8504
Mailing address
1270 CONSTITUTION CT, APT 102, HARRISONBURG, VA 22802
(703) 206-8504
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401417571
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401417571
DENTAL LICENSE NUMBER
VA
Enumeration date
08/03/2021
Last updated
08/03/2021
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