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General NPI Number Information
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NPI Number | 1366058604
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Entity Type | Organization
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Legal Business Name | SHERWOOD ORAL SURGERY
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Dates
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Enumeration Date | 09/22/2020
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Last Update Date | 09/22/2020
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Provider Practice Location Address
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Address Line | 174B EXECUTIVE DR
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City | DANVILLE
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State | VA
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Zip | 24541-4100
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Country | US
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Telephone | 434-792-4046
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Fax | 434-792-7200
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Provider Business Mailing Address
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Address Line | 174B EXECUTIVE DR
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City | DANVILLE
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State | VA
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Zip | 24541-4100
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Country | US
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Telephone | 434-792-4046
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Fax | 434-792-7200
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Authorized Official
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Title or Position | OFFICE ASSISTANT
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Name | TAMMY C MCVAY
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Credential |
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Telephone | 434-792-4046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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