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General NPI Number Information
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NPI Number | 1770679110
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Entity Type | Organization
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Legal Business Name | OWENS AND DORFMAN LTD
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4356 4 BONNEY RD SUITE 101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452
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Country | US
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Telephone | 757-340-7000
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Fax | 757-498-6498
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Provider Business Mailing Address
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Address Line | 4356 4 BONNEY RD SUITE 101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452
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Country | US
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Telephone | 757-340-7000
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Fax | 757-498-6498
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | HOWARD STANLEY DORFMAN
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Credential | DMD
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Telephone | 757-340-7000
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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 | 2006113958R
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License Number State | VA
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