| Wm Graham Gardner Dds Pc | |
|
1206 Willow Lawn Drive Richmond VA 23226-1409 | |
| (804) 282-6436 | |
| (804) 282-8297 |
| Full Name | Wm Graham Gardner Dds Pc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1206 Willow Lawn Drive, Richmond, Virginia |
| Authorized Official Name and Position | William Graham Gardner (OWNER) |
| Authorized Official Contact | 8042826436 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wm Graham Gardner Dds Pc 1206 Willow Lawn Drive Richmond VA 23226-1409 Ph: (804) 282-6436 | Wm Graham Gardner Dds Pc 1206 Willow Lawn Drive Richmond VA 23226-1409 Ph: (804) 282-6436 |
| NPI Number | 1972513208 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972513208 | NPI | - | NPPES |
| 9178639 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 0401008926 (Virginia) | Primary |
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