Individual
ANSHELLE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
561 FIRST COLONIAL BLVD, STE 104, V IRGINIA BEACH, VA 23451
(757) 648-7473
Mailing address
18492 E RANCH RD, QUEEN CREEK, AZ 85142-5397
(702) 755-5395
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401419243
VA
122300000X
Dentist
DN1859406
MA
1223G0001X
General Practice Dentistry
D012016
AZ
Other
Enumeration date
05/25/2022
Last updated
11/29/2024
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