Sparkle Pediatric Dentistry | |
11934 W Broad St Ste 120 Henrico VA 23233-1100 | |
(804) 746-7382 | |
(804) 746-3025 |
Full Name | Sparkle Pediatric Dentistry |
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Speciality | Dentist - Pediatric Dentistry |
Location | 11934 W Broad St Ste 120, Henrico, Virginia |
Authorized Official Name and Position | Holly C Lewis (PEDIATRIC DENTAL SPECIALIST) |
Authorized Official Contact | 8047467382 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Sparkle Pediatric Dentistry 11934 W Broad St Ste 120 Henrico VA 23233-1100 Ph: (804) 746-7382 | Sparkle Pediatric Dentistry 11934 W Broad St Ste 120 Henrico VA 23233-1100 Ph: (804) 746-7382 |
NPI Number | 1821535444 |
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Provider Enumeration Date | 01/20/2017 |
Last Update Date | 09/23/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821535444 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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