MEDICARE: JACQUELINE JOHNSON CURL DDS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	0401006645	VA

General Provider Information

NPI Number	:	1619000270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JACQUELINE JOHNSON CURL DDS PC

Provider Business Mailing Address
First Line	:	5007 BROOK RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-3416
Country	:	US
Telephone Number	:	804-264-4068
Fax Number	:	804-553-3855

Provider Business Practice Location Address
First Line	:	5007 BROOK RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-3416
Country	:	US
Telephone Number	:	804-264-4068
Fax Number	:	804-553-3855

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JACQUELINE YVONNE JOHNSONCURL
Credential	:	DDS
Telephone Number	:	804-264-4068

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	08/22/2020

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