| Family Dentistry Of Short Pump | |
|
11549 Nuckols Rd Ste A Glen Allen VA 23059-5664 | |
| (804) 527-2982 | |
| (804) 527-2987 |
| Full Name | Family Dentistry Of Short Pump |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11549 Nuckols Rd Ste A, Glen Allen, Virginia |
| Authorized Official Name and Position | Kim Wilson (CRED SUPERVISOR) |
| Authorized Official Contact | 2175405170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dentistry Of Short Pump 11549 Nuckols Rd Ste A Glen Allen VA 23059-5664 Ph: (804) 527-2982 | Family Dentistry Of Short Pump 11549 Nuckols Rd Ste A Glen Allen VA 23059-5664 Ph: (804) 527-2982 |
| NPI Number | 1962813402 |
|---|---|
| Provider Enumeration Date | 05/19/2014 |
| Last Update Date | 05/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962813402 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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