Organization
SOUTH RIVER DENTISTRY
Active
Parent organization
CENTRAL VIRGINIA DENTAL CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL VIRGINIA DENTAL CARE
Authorized official
DR. JEFFERSON THAIR BLACKBURN DDS (OWNER)
(804) 378-7888
Entity
Organization
Contact information
Practice address
2301 ROBIOUS STATION CIR, MIDLOTHIAN, VA 23113-2124
(804) 378-7888
Mailing address
2301 ROBIOUS STATION CIR, MIDLOTHIAN, VA 23113-2124
(804) 378-7888
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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