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General NPI Number Information
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NPI Number | 1982896205
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Entity Type | Organization
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Legal Business Name | D J BICKERS, DDS, PLC
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 08/10/2007
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Provider Practice Location Address
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Address Line | 1101 E JEFFERSON ST SUITE 5
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-5353
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Country | US
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Telephone | 434-984-6400
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Fax | 434-984-6408
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Provider Business Mailing Address
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Address Line | 1101 E JEFFERSON ST SUITE 5
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-5353
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Country | US
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Telephone | 434-984-6400
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Fax | 434-984-6408
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. DUANE JOSEPH BICKERS
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Credential | D.D.S.
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Telephone | 434-984-6400
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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 | 0401008742
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License Number State | VA
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