Healthcare Provider Details

I. General information

NPI: 1710348537
Provider Name (Legal Business Name): DEPARTMENT OF HEALTH, GOVT OF THE VIRGIN ISLAND, DENTAL PUBLIC HELATH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2016
Last Update Date: 03/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 ESTATE RICHMOND DEPT OF HEALTH CHARLES HARWOOD CO
CHRISTIANSTED VI
00820
US

IV. Provider business mailing address

3500 ESTATE RICHMOND DEPT OF HEALTH CHARLES HARWOOD CO
CHRISTIANSTED VI
00820
US

V. Phone/Fax

Practice location:
  • Phone: 340-718-1311
  • Fax: 340-718-1376
Mailing address:
  • Phone: 340-718-1311
  • Fax: 340-718-1376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MISS LORNA MILLER
Title or Position: REVENUE MANAGER
Credential:
Phone: 340-718-1311