Healthcare Provider Details

I. General information

NPI: 1386750800
Provider Name (Legal Business Name): ARTHUR H DIAMOND DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 J CLYDE MORRIS BLVD
NEWPORT NEWS VA
23601-1927
US

IV. Provider business mailing address

416 J CLYDE MORRIS BLVD PENINSULA HEALTH DISTRICT
NEWPORT NEWS VA
23601-1927
US

V. Phone/Fax

Practice location:
  • Phone: 757-594-7305
  • Fax: 757-594-7714
Mailing address:
  • Phone: 757-594-7305
  • Fax: 757-594-7714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number0401004976
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: