Individual
KEVIN M NOALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
521 N 11TH ST, RICHMOND, VA 23298-5045
(804) 828-2522
Mailing address
1200 SEMMES AVE, RICHMOND, VA 23224-2178
(804) 828-2522
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401414151
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952710501
—
VA
Enumeration date
11/23/2005
Last updated
09/05/2015
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