Individual
DR. GORDON TIMOTHY WITCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11601 IRON BRIDGE RD, SUITE 204, CHESTER, VA 23831-1466
(804) 717-5100
(804) 717-5103
Mailing address
11601 IRON BRIDGE RD, SUITE 204, CHESTER, VA 23831-1466
(804) 717-5100
(804) 717-5103
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401005310
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107016
ANTHEM
VA
Enumeration date
01/17/2007
Last updated
07/02/2014
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