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General NPI Number Information
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NPI Number | 1154726115
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Entity Type | Organization
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Legal Business Name | WILLIAMSBURG FAMILY DENTISTRY, PC
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Dates
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Enumeration Date | 11/03/2014
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Last Update Date | 11/03/2014
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Provider Practice Location Address
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Address Line | 213 BULIFANTS BLVD SUITE E
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-5733
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Country | US
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Telephone | 757-345-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 213 BULIFANTS BLVD SUITE E
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-5733
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Country | US
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Telephone | 757-345-5500
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. BRETT DUNNILL
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Credential | DDS
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Telephone | 757-345-5500
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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 | 0401411453
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401413221
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401410542
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License Number State | VA
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