Provider Demographics
NPI:1164481453
Name:WARD, GLORIA ELENA (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:ELENA
Last Name:WARD
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 WESTERRE PKWY
Mailing Address - Street 2:SUITE D
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1326
Mailing Address - Country:US
Mailing Address - Phone:804-270-7940
Mailing Address - Fax:804-270-7941
Practice Address - Street 1:3701 WESTERRE PKWY
Practice Address - Street 2:SUITE D
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1326
Practice Address - Country:US
Practice Address - Phone:804-270-7940
Practice Address - Fax:804-270-7941
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401404107561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice