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General NPI Number Information
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NPI Number | 1447301346
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Entity Type | Individual
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Provider Name | BRIAN SCOTT LEVITIN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3938 SPRINGFIELD RD
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City | GLEN ALLEN
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State | VA
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Zip | 23060-4119
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Country | US
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Telephone | 804-747-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 11800 PARK COMMONS CT
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City | GLEN ALLEN
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State | VA
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Zip | 23059-8501
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Country | US
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Telephone | 804-270-4853
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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 | 0401410905
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License Number State | VA
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