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Individual

DR. JITENDRA JETHWANI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
520 N 12TH ST, LYONS DENTAL BUILDING, 4 TH FLOOR, ROOM 406,SUITE 456, RICHMOND, VA 23298-0566
(804) 828-2977
(804) 828-3159
Mailing address
520 N 12TH ST, LYONS DENTAL BUILDING, 4 TH FLOOR, ROOM 406,SUITE 456, RICHMOND, VA 23298-0566
(804) 828-2977
(804) 828-3159

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401415792
VA

Other

Enumeration date
07/19/2016
Last updated
11/14/2018
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