Healthcare Provider Details

I. General information

NPI: 1093559403
Provider Name (Legal Business Name): FRANCISCO MESA DMD PPLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 08/31/2024
Certification Date: 08/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008 BREMO RD STE 104
RICHMOND VA
23226-2443
US

IV. Provider business mailing address

2008 BREMO RD STE 104
RICHMOND VA
23226-2443
US

V. Phone/Fax

Practice location:
  • Phone: 804-282-0510
  • Fax: 804-282-1346
Mailing address:
  • Phone: 804-282-0510
  • Fax: 804-282-1346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: FRANCISCO MESA
Title or Position: DENTIST OWNER
Credential: DMD
Phone: 804-282-0510