Organization
DRS. SODERQUIST & WEIS, P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JUDY H BURRUSS (OFFICE MANAGER)
(434) 971-9601
Entity
Organization
Contact information
Practice address
1101 E JEFFERSON ST, CHARLOTTESVILLE, VA 22902-5353
(434) 971-9601
(434) 971-9646
Mailing address
1101 E JEFFERSON ST, CHARLOTTESVILLE, VA 22902-5353
(434) 971-9601
(434) 971-9646
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
S4157/ W8596
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9178262
—
VA
05
—
9178339
—
VA
Enumeration date
07/29/2006
Last updated
07/21/2022
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