Healthcare Provider Details

I. General information

NPI: 1871556910
Provider Name (Legal Business Name): JOHN ARTHUR SVIRSKY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 01/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 N 12TH ST
RICHMOND VA
23298-5064
US

IV. Provider business mailing address

PO BOX 980566
RICHMOND VA
23298-0566
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-3630
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number0401004495
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: