Healthcare Provider Details

I. General information

NPI: 1831289537
Provider Name (Legal Business Name): J RAWLS SAECKER DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 10/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23185 FRONT ST
ACCOMAC VA
23301
US

IV. Provider business mailing address

PO BOX 339
ACCOMAC VA
23301
US

V. Phone/Fax

Practice location:
  • Phone: 757-787-4425
  • Fax: 757-787-8770
Mailing address:
  • Phone: 757-787-4425
  • Fax: 757-787-8770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: J RAWLS SAECKER
Title or Position: DENTIST PRESIDENT
Credential: DDS
Phone: 757-787-4425