Individual
KEAIRA THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
719 N 25TH ST, RICHMOND, VA 23223-6539
(804) 780-0840
Mailing address
719 N 25TH ST, RICHMOND, VA 23223-6539
(804) 780-0840
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401417539
VA
Other
Enumeration date
06/30/2021
Last updated
06/30/2021
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