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Organization

DARCHELLE BRAXTON DMD PC

Active
Other names
Toothbeary Pediatric Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DARCHELLE BRAXTON DMD (PEDIATRIC DENTIST)
(804) 709-8166
Entity
Organization

Contact information

Practice address
4300 POUNCEY TRACT ROAD SUITE I, GLEN ALLEN, VA 23060
(804) 709-8166
Mailing address
4300 POUNCEY TRACT ROAD SUITE I, GLEN ALLEN, VA 23060
(804) 709-8166

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401414243
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03647894
VA
Enumeration date
05/17/2016
Last updated
05/17/2016
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