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General NPI Number Information
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NPI Number | 1710040191
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Entity Type | Organization
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Legal Business Name | LYNCHBURG HEALTH DEPT. DENTAL OFFICE
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 1900 THOMSON DR
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City | LYNCHBURG
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State | VA
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Zip | 24501-1009
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Country | US
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Telephone | 434-947-6777
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 THOMSON DR
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City | LYNCHBURG
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State | VA
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Zip | 24501-1009
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Country | US
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Telephone | 434-947-6777
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Fax |
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Authorized Official
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Title or Position | DIRECTOR CENTRAL VA. HEALTH DISTRIC
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Name | KATHERINE V NICHOLS
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Credential | MD
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Telephone | 434-947-6777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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