Healthcare Provider Details

I. General information

NPI: 1801197199
Provider Name (Legal Business Name): SORIN URAM-TUCULESCU DDS, MS, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2010
Last Update Date: 11/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 N 11TH ST VCU DENTAL FACULTY PRACTICE
RICHMOND VA
23298-5045
US

IV. Provider business mailing address

521 N 11TH ST VCU SC OF DENT DEPT OF PROSTHODONT WOOD BDG SUITE 304 D
RICHMOND VA
23298-5045
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-3368
  • Fax:
Mailing address:
  • Phone: 804-628-3742
  • Fax: 804-827-1017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number0401412836
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: