Heavenly Smiles Dentistry, Pllc

NPI 1487966339 - Dentist - 122300000X

NPI Details
NPI 1487966339
Enumeration Date 07/08/2010
Last Updated 07/08/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name JUAN ANTONIO JUAN
Position DENTIST
Phone (804) 892-1330
Fax
Practice Location
1100A BOULEVARD
COLONIAL HEIGHTS VA, 23834-3001, US
Phone (804) 892-1330
Fax
Business Location
PO BOX 1059
COLONIAL HEIGHTS VA, 23834-1059, US
Phone (804) 892-1330
Fax
Toxanomy
Taxonomy Code 122300000X
License State Virginia
License Number 0401412139
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According to our database, Heavenly Smiles Dentistry, Pllc NPI is 1487966339, taxonomy code is 122300000X and license number is 0401412139, license state is located at Virginia. Heavenly Smiles Dentistry, Pllc physically located at 1100a Boulevard, Colonial Heights VA, 23834-3001. NPI Number 1033115704 has the healthcare provider type.

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1487966339 NPI number is provided on an as is basis without warranty of any kind. 1487966339 is maintained by the National Plan & Provider Enumeration System. The contents of Heavenly Smiles Dentistry, Pllc are for informational purposes only.