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General NPI Number Information
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NPI Number | 1285917864
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Entity Type | Organization
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Legal Business Name | FRANCISCO A AVILES DDS PC
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Dates
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Enumeration Date | 09/21/2011
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Last Update Date | 09/21/2011
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Provider Practice Location Address
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Address Line | 2125 MCCOMAS WAY STE 105
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-3986
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Country | US
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Telephone | 757-301-6999
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Fax |
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Provider Business Mailing Address
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Address Line | 2125 MCCOMAS WAY STE 105
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-3986
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Country | US
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Telephone | 757-301-6999
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FRANCISCO AVILES
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Credential | DDS
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Telephone | 757-301-6999
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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 | 0401413007
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License Number State | VA
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