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General NPI Number Information
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NPI Number | 1134509227
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Entity Type | Individual
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Provider Name | AUTUMN ALLGOOD MAYERS DDS
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Gender | Female
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Dates
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Enumeration Date | 06/03/2015
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Last Update Date | 06/03/2015
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Provider Practice Location Address
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Address Line | 8275 NEW ASHCAKE RD
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-4037
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Country | US
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Telephone | 804-754-6758
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Fax |
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Provider Business Mailing Address
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Address Line | 5921 HARBOUR LN STE 100
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-2161
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401414858
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License Number State | VA
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