Healthcare Provider Details

I. General information

NPI: 1003903733
Provider Name (Legal Business Name): WILLIAM JOSEPH VIGLIONE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3025 BERKMAR DR VIGLIONE HAINES AND ASSOCIATES
CHARLOTTESVILLE VA
22901-1456
US

IV. Provider business mailing address

3025 BERKMAR DR SUITE 4
CHARLOTTESVILLE VA
22901-1456
US

V. Phone/Fax

Practice location:
  • Phone: 434-973-4355
  • Fax: 434-973-8079
Mailing address:
  • Phone: 434-973-4355
  • Fax: 434-973-8079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401004316
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: