Organization
DENTAL PROFESSIONALS OF VIRGINIA, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF VIRGINIA, P.C.
Other names
Family Dentistry of Short Pump
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF VIRGINIA, P.C.
Authorized official
KIM WILSON (CRED SUPERVISOR)
(217) 540-5170
Entity
Organization
Contact information
Practice address
11549 NUCKOLS RD STE A, GLEN ALLEN, VA 23059-5664
(804) 527-2982
(804) 527-2987
Mailing address
11549 NUCKOLS RD STE A, GLEN ALLEN, VA 23059-5664
(804) 527-2982
(804) 527-2987
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/19/2014
Last updated
05/19/2014
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