Organization
SPARKLE PEDIATRIC DENTISTRY
Active
Parent organization
CENTRAL VIRGINIA DENTAL CARE PLC
Other names
SPARKLE PEDIATRIC DENTISTRY
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL VIRGINIA DENTAL CARE PLC
Authorized official
HOLLY C LEWIS DMD, MS (PEDIATRIC DENTAL SPECIALIST)
(804) 746-7382
Entity
Organization
Contact information
Practice address
11934 W BROAD ST STE 120, HENRICO, VA 23233-1100
(804) 746-7382
(804) 746-3025
Mailing address
11934 W BROAD ST STE 120, HENRICO, VA 23233-1100
(804) 746-7382
(804) 746-3025
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
01/20/2017
Last updated
09/23/2021
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