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NPI Code Detail

MEDICARE: DR. MARIA VICTORIA THROCKMORTON DDS

MEDICARE: DR. MARIA VICTORIA THROCKMORTON DDS
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
11223G0001XGeneral Practice Dentistry0401411061VA

General Provider Information

NPI Number : 1720047004
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARIA VICTORIA THROCKMORTON DDS
Provider Business Mailing Address
First Line : 2829 SHORE DR STE 100
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23451-1498
Country : US
Telephone Number : 757-333-6866
Fax Number :
Provider Business Practice Location Address
First Line : 2829 SHORE DR STE 100
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23451-1498
Country : US
Telephone Number : 757-333-6866
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 08/21/2019

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Directions to “ DR. MARIA VICTORIA THROCKMORTON DDS” Practice Location

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