Provider Demographics
NPI:1043502198
Name:SCOTTSVILLE FAMILY DENTISTRY
Entity Type:Organization
Organization Name:SCOTTSVILLE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.D.S.
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:BAIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-286-3326
Mailing Address - Street 1:PO BOX 667
Mailing Address - Street 2:
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24590-0667
Mailing Address - Country:US
Mailing Address - Phone:434-286-3326
Mailing Address - Fax:434-286-2973
Practice Address - Street 1:531 VALLEY ST
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24590-4983
Practice Address - Country:US
Practice Address - Phone:434-286-3326
Practice Address - Fax:434-286-2973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010082131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty