Healthcare Provider Details

I. General information

NPI: 1699933671
Provider Name (Legal Business Name): JANICE L.USNICK, DMD & CRAIG W FLAHERTY, DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 W SPOTSWOOD AVE
ELKTON VA
22827-1169
US

IV. Provider business mailing address

160 W SPOTSWOOD AVE
ELKTON VA
22827-1169
US

V. Phone/Fax

Practice location:
  • Phone: 540-298-1581
  • Fax: 540-298-9655
Mailing address:
  • Phone: 540-298-1581
  • Fax: 540-298-9655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401410405
License Number StateVA

VIII. Authorized Official

Name: DR. JANICE L. USNICK
Title or Position: PRESIDENT
Credential: DMD
Phone: 540-298-1581