Individual
WILLIAM VACCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
5921 HARBOUR LN STE 400, MIDLOTHIAN, VA 23112-2158
(804) 739-9191
Mailing address
5921 HARBOUR LN STE 400, MIDLOTHIAN, VA 23112-2158
(804) 739-9191
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401416626
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/15/2019
Last updated
05/19/2020
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