Organization
CHARLES S LLEWELLYN III DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES SILAS LLEWELLYN III DDS (PRESIDENT)
(757) 428-2571
Entity
Organization
Contact information
Practice address
1729 WILDWOOD DR, #104, VIRGINIA BEACH, VA 23454-3176
(757) 428-2571
(757) 502-7229
Mailing address
1729 WILDWOOD DR, #104, VIRGINIA BEACH, VA 23454-3176
(757) 428-2571
(757) 502-7229
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
VA6246
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
274488
ANTHEM
VA
Enumeration date
05/21/2007
Last updated
02/16/2016
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