Organization
PROHEALTH SENIOR SERVICES OF VIRGINIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM F PROFFITT JR. DDS (OWNER)
(844) 700-0088
Entity
Organization
Contact information
Practice address
811 HIGH ST, MARYVILLE, TN 37804-5030
(844) 700-0088
Mailing address
8028 HAMPTON LAKE DR, TAMPA, FL 33647-3558
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401413088
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649296906
NPI
—
Enumeration date
04/30/2018
Last updated
04/30/2018
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