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General NPI Number Information
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NPI Number | 1306343868
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Entity Type | Organization
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Legal Business Name | DANVILLE DENTAL ASSOCIATES, PC
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Dates
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Enumeration Date | 04/11/2018
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Last Update Date | 08/09/2019
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Provider Practice Location Address
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Address Line | 5011 RIVERSIDE DR STE B
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City | DANVILLE
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State | VA
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Zip | 24541-5642
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Country | US
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Telephone | 434-822-1332
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Fax | 434-822-1336
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Provider Business Mailing Address
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Address Line | 5011 RIVERSIDE DR STE B
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City | DANVILLE
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State | VA
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Zip | 24541-5642
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Country | US
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Telephone | 434-822-1332
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Fax | 434-822-1336
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Authorized Official
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Title or Position | DENTIST
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Name | DR. CHRISTOPHER A PAYNE
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Credential | DDS
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Telephone | 434-822-1332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401410725
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License Number State | VA
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