Organization
LOUISA DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LILIAN R PEAKE MD (DIRECTOR)
(434) 972-6219
Entity
Organization
Contact information
Practice address
101 WOOLFOLK AVE STE 202, LOUISA, VA 23093-4264
(540) 967-4439
(540) 967-4452
Mailing address
PO BOX 7546, CHARLOTTESVILLE, VA 22906-7546
(434) 972-6219
(434) 972-4310
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008450421
—
VA
Enumeration date
11/16/2006
Last updated
11/07/2023
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