Organization
SOUTHSIDE FAMILY AND COSMETIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONYA ADRENA PARRIS-WILKINS D.D.S. (PRESIDENT)
(804) 520-5009
Entity
Organization
Contact information
Practice address
3505 BOULEVARD, COLONIAL HEIGHTS, VA 23834-1319
(804) 520-5009
(804) 520-0901
Mailing address
3505 BOULEVARD, COLONIAL HEIGHTS, VA 23834-1319
(804) 520-5009
(804) 520-0901
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411798
VA
Other
Enumeration date
02/12/2012
Last updated
02/12/2012
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