Individual
KAYLA NIQUEL GORHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1851 MACGREGOR DOWNS RD APT R, GREENVILLE, NC 27834-5925
(252) 737-7000
Mailing address
520 N 12TH ST, RICHMOND, VA 23298-5064
(804) 828-9095
(804) 828-9095
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401419440
VA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/10/2023
Last updated
06/02/2025
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