Organization
MARYBETH WICKER, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARYBETH WICKER (PRESIDENT)
(804) 320-3200
Entity
Organization
Contact information
Practice address
9017 FOREST HILL AVE, RICHMOND, VA 23235-3051
(804) 320-3200
Mailing address
9017 FOREST HILL AVE, RICHMOND, VA 23235-3051
(804) 320-3200
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0401410286
VA
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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