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General NPI Number Information
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NPI Number | 1689918252
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Entity Type | Organization
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Legal Business Name | DHAKAR FAMILY DENTISTRY
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Dates
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Enumeration Date | 11/20/2012
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Last Update Date | 11/20/2012
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Provider Practice Location Address
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Address Line | 1633 WILLIAMSBURG RD
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City | RICHMOND
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State | VA
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Zip | 23231-1543
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Country | US
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Telephone | 804-447-4801
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Fax | 804-447-4803
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Provider Business Mailing Address
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Address Line | 1633 WILLIAMSBURG RD
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City | RICHMOND
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State | VA
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Zip | 23231-1543
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Country | US
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Telephone | 804-447-4801
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Fax | 804-447-4803
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Authorized Official
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Title or Position | DENTIST, PRESIDENT
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Name | DR. SURYA P DHAKAR
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Credential | DDS
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Telephone | 804-447-4801
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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 | 0401410078
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License Number State | VA
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