Individual
DR. DAVID RANDOLPH THROCKMORTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3145 VIRGINIA BEACH BVLD, 104, VIRGINIA BEACH, VA 23452-6183
(757) 340-7602
Mailing address
511 23RD ST, VIRGINIA BEACH, VA 23451-4005
(757) 422-2190
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411064
VA
Other
Enumeration date
03/24/2006
Last updated
07/08/2007
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