Organization
DENTAL PROFESSIONALS OF VIRGINIA, P.C
Active
Parent organization
DENTAL PROFESSIONALS OF VIRGINIA, P.C
Other names
Broadlands Complete Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF VIRGINIA, P.C
Authorized official
LINDSAY BEARDEN (INSURANE/CREDENTIALING)
(217) 540-5100
Entity
Organization
Contact information
Practice address
43170 SOUTHERN WALK PLZ, SUITE 116, BROADLANDS, VA 20148-4464
(703) 957-7066
Mailing address
43170 SOUTHERN WALK PLZ, SUITE 116, BROADLANDS, VA 20148-4464
(703) 957-7066
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/04/2013
Last updated
01/11/2014
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