Organization
VCU SCHOOL OF DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANI WILSON (FINANCIAL COORDINATOR)
(804) 827-1960
Entity
Organization
Contact information
Practice address
521 N 11TH ST, ROOM 315, RICHMOND, VA 23298-5045
(804) 828-9095
(804) 827-1244
Mailing address
521 N 11TH ST, ROOM 315, RICHMOND, VA 23298-5045
(804) 828-9095
(804) 827-1244
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
VA
Other
Enumeration date
07/23/2007
Last updated
07/23/2007
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