Organization
RICHMOND VIRGINIA ORTHODONTICS OF SHORT PUMP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING)
(612) 859-0444
Entity
Organization
Contact information
Practice address
3400 HAYDENPARK LN STE 201, HENRICO, VA 23233-7867
(804) 884-9906
Mailing address
3400 HAYDENPARK LN STE 201, HENRICO, VA 23233-7867
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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