Individual
MS. MERRILYN PETERSON PRUCHA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1550 TOMCAT BLVD, VIRGINIA BEACH, VA 23460-2218
(757) 314-7190
Mailing address
1901 EASTOVER CT, VIRGINIA BEACH, VA 23464-8911
(757) 314-7190
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
0402002559
VA
Other
Enumeration date
01/20/2006
Last updated
07/08/2007
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