Provider Demographics
NPI:1114036191
Name:CHAD M VAN SCYOC DDS PC
Entity Type:Organization
Organization Name:CHAD M VAN SCYOC DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:VAN SCYOC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PC
Authorized Official - Phone:804-270-7425
Mailing Address - Street 1:2821 N PARHAM RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4412
Mailing Address - Country:US
Mailing Address - Phone:804-270-7425
Mailing Address - Fax:804-270-0083
Practice Address - Street 1:2821 N PARHAM RD
Practice Address - Street 2:SUITE 202
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4412
Practice Address - Country:US
Practice Address - Phone:804-270-7425
Practice Address - Fax:804-270-0083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty