Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
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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