Individual
JESSICA LYNN BUCKWALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 S JEFFERSON ST, ROANOKE, VA 24016-4724
(540) 855-6800
Mailing address
3553 MURCHIES HILL RD, RICHMOND, VA 23234-3327
(703) 473-3308
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401417442
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
Other
Enumeration date
04/21/2020
Last updated
10/07/2025
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