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General NPI Number Information
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NPI Number | 1528356078
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Entity Type | Organization
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Legal Business Name | CAMPBELL S. DELK, DDS, PC
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 4440 SPRINGFIELD RD SUITE 104
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City | GLEN ALLEN
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State | VA
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Zip | 23060-3410
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Country | US
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Telephone | 804-747-9511
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Fax | 804-762-8930
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Provider Business Mailing Address
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Address Line | 4440 SPRINGFIELD RD SUITE 104
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City | GLEN ALLEN
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State | VA
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Zip | 23060-3410
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Country | US
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Telephone | 804-747-9511
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Fax | 804-762-8930
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CAMPBELL S DELK
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Credential | DDS
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Telephone | 804-747-9511
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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 | 0401004326
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License Number State | VA
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