Individual
DR. LOUIS FORMICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
520 N 12TH ST, RICHMOND, VA 23298-5064
(804) 828-3368
Mailing address
520 N 12TH ST, RICHMOND, VA 23298-5064
(804) 828-3368
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401414852
VA
Other
Enumeration date
06/15/2015
Last updated
01/28/2019
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