Healthcare Provider Details

I. General information

NPI: 1255442109
Provider Name (Legal Business Name): MARTHA DAWSON DDS PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4025 MECHANICSVILLE TURNPIKE
RICHMOND VA
23223
US

IV. Provider business mailing address

4025 MECHANICSVILLE TURNPIKE
RICHMOND VA
23223
US

V. Phone/Fax

Practice location:
  • Phone: 804-321-6800
  • Fax: 804-321-8800
Mailing address:
  • Phone: 804-321-6800
  • Fax: 804-321-8800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MARTHA ALLEN DAWSON
Title or Position: OWNER
Credential: DDS
Phone: 804-321-6800