Individual
JESSICA OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
190 WATSON STREET, DANVILLE, VA 24540
(434) 792-0700
(434) 792-5325
Mailing address
190 WATSON STREET, DANVILLE, VA 24541
(434) 792-0700
(434) 792-5325
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
FO2244565
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
465040124
—
VA
Enumeration date
08/20/2010
Last updated
08/20/2014
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