Individual
DR. DANIEL TIESWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11453 ROBIOUS RD, NORTH CHESTERFIELD, VA 23235-4309
(804) 330-4324
Mailing address
11453 ROBIOUS RD, RICHMOND, VA 23235
(804) 330-4324
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401414873
VA
Other
Enumeration date
06/09/2015
Last updated
06/30/2015
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