Individual
NOAH FIXELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
BUREAU OF MED AND SURG CCPD, 554 KEILY STREET, JACKSONVILLE, VA 32212
(757) 953-7011
Mailing address
BUREAU OF MED AND SURG CCPD, 554 KEILY STREET, JACKSONVILLE, VA 32212
(757) 953-7011
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
O401415312
VA
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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