Organization
VISTA DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITSU JOSHI DDS (OWNER/SOLE MEMBER)
(804) 672-7070
Entity
Organization
Contact information
Practice address
9195 STAPLES MILL RD, HENRICO, VA 23228-2027
(804) 672-7070
Mailing address
PO BOX 2879, GLEN ALLEN, VA 23058-2879
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411436
VA
Other
Enumeration date
06/09/2011
Last updated
06/09/2011
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