Organization
GB DEVERA DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON SHEPPARD (OFFICE MANAGER)
(804) 464-1852
Entity
Organization
Contact information
Practice address
2373 COLONY CROSSING PL, MIDLOTHIAN, VA 23112-4280
(804) 464-1852
Mailing address
2373 COLONY CROSSING PL, MIDLOTHIAN, VA 23112-4280
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
0401410103
VA
Other
Enumeration date
04/01/2008
Last updated
04/01/2008
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