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General NPI Number Information
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NPI Number | 1659592897
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Entity Type | Organization
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Legal Business Name | THOMAS WOODARD DDS P C
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 415 N MILITARY HWY STE 8
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City | NORFOLK
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State | VA
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Zip | 23502-5407
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Country | US
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Telephone | 757-455-5040
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Fax | 757-455-5043
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Provider Business Mailing Address
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Address Line | 415 N MILITARY HWY STE 8
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City | NORFOLK
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State | VA
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Zip | 23502-5407
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Country | US
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Telephone | 757-455-5040
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Fax | 757-455-5043
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. THOMAS WOODARD
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Credential | DDS
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Telephone | 757-455-5040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 401008079
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License Number State | VA
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