Individual
CAROLYN RECUPERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5954 HARBOUR PARK DR, MIDLOTHIAN, VA 23112-2163
(804) 597-9656
Mailing address
1215 LEE ST BOX 800740, CHARLOTTESVILLE, VA 22908-0816
(434) 924-1774
(434) 243-6378
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401418929
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2024
Last updated
04/20/2026
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