Individual
DR. JAIME WOODALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4721 KINGS MOUNTAIN RD, COLLINSVILLE, VA 24078-1274
(276) 647-3802
Mailing address
4721 KINGS MOUNTAIN RD, COLLINSVILLE, VA 24078-1274
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401415310
VA
Other
Enumeration date
07/01/2016
Last updated
02/27/2019
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