Organization
HENDRICK B. TAFO-TABUE, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENDRICK BASTIAAN TAFO-TABUE DDS (OWNER)
(832) 713-2497
Entity
Organization
Contact information
Practice address
12201 TIVERTON LN, GLEN ALLEN, VA 23059-7015
(832) 713-2497
Mailing address
12201 TIVERTON LN, GLEN ALLEN, VA 23059-7015
(832) 713-2497
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401413401
VA
Other
Enumeration date
08/25/2014
Last updated
08/25/2014
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