Individual
JESSICA KHIET QUACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4940 KINGS MOUNTAIN RD, COLLINSVILLE, VA 24078-1812
(276) 647-1494
Mailing address
770 PINEY FOREST RD, DANVILLE, VA 24540-2876
(434) 799-8825
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401417002
VA
122300000X
Dentist
Primary
12069
NC
Other
Enumeration date
07/13/2020
Last updated
04/06/2026
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