Organization
VIRGINIA COMMONWEALTH UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETSY ANN HAGAN DDS, MBA (SENIOR ASSOCIATE DEAN)
(804) 828-7978
Entity
Organization
Contact information
Practice address
520 N 12TH ST, LYONS BUILDING, ROOM 456, RICHMOND, VA 23298-0566
(804) 828-7978
Mailing address
520 N 12TH ST, LYONS BUILDING, ROOM 456, P.O. BOX 980566, RICHMOND, VA 23298-0566
(804) 828-7978
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0401005311
VA
Other
Enumeration date
04/23/2007
Last updated
08/22/2020
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