Individual
DR. LIARA DESTINY VINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1000 E BROAD ST FL 6, RICHMOND, VA 23219-1930
(804) 828-9095
Mailing address
1001 E BYRD ST APT 6701, RICHMOND, VA 23219-4310
(215) 870-6587
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS043071
PA
1223G0001X
General Practice Dentistry
0401417971
VA
1223P0221X
Pediatric Dentistry
Primary
DS043071
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/11/2020
Last updated
06/03/2025
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