Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
Other names
Chesterfield County Health Department Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM R NELSON M.D.,MPH (DISTRICT HEALTH DIRECTOR)
(804) 751-4385
Entity
Organization
Contact information
Practice address
9501 LUCY CORR CIR, SUITE 404, CHESTERFIELD, VA 23832-6697
(804) 748-1752
(804) 751-4497
Mailing address
PO BOX 100, CHESTERFIELD, VA 23832-0002
(804) 751-1743
(804) 751-4497
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007461
DORAL DENTAL USA
—
05
—
008450161
—
VA
01
—
107016
ANTHEM BC BS OF VA
VA
Enumeration date
09/11/2006
Last updated
07/28/2008
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