Individual
TASHA N WILLOUGHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2557 COWAN BLVD, FREDERICKSBURG, VA 22401-8440
(540) 551-5550
(540) 371-0000
Mailing address
2557 COWAN BLVD, FREDERICKSBURG, VA 22401-8440
(540) 551-5550
(540) 371-0000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401411109
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9179325
—
VA
Enumeration date
01/31/2006
Last updated
08/10/2023
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