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Organization

LUCY CORR FOUNDATION, INC.

Active
Other names
Lucy Corr Dental Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TAMMY HOLBERT SHACKELFORD (EXECUTIVE DIRECTOR)
(804) 467-2255
Entity
Organization

Contact information

Practice address
6800 LUCY CORR BLVD., CHESTERFIELD, VA 23832-6657
(804) 467-2255
Mailing address
6800 LUCY CORR BLVD., CHESTERFIELD, VA 23832-6657
(804) 467-2255

Taxonomy

Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary

Other

Enumeration date
06/23/2021
Last updated
07/01/2021
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