Organization
CHILDREN'S DENTISTRY OF CHARLOTTESVILLE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN WILL DDS (SHAREHOLDER)
(434) 817-1817
Entity
Organization
Contact information
Practice address
1470 PANTOPS MOUNTAIN PL, CHARLOTTESVILLE, VA 22911-4600
(434) 817-1817
(434) 817-1819
Mailing address
1470 PANTOPS MOUNTAIN PL, CHARLOTTESVILLE, VA 22911-4600
(434) 817-1817
(434) 817-1819
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401412570
VA
122300000X
Dentist
0401413819
VA
122300000X
Dentist
Primary
0401414088
VA
1223D0004X
Dental Anesthesiology
0401412934
VA
1223D0004X
Dental Anesthesiology
0401413770
VA
1223P0221X
Pediatric Dentistry
0401410463
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
753148626
VA
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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