Provider Demographics
NPI:1184673063
Name:PIASCIK, CHRISTINE LARSEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:LARSEN
Last Name:PIASCIK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1769 JAMESTOWN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-2368
Mailing Address - Country:US
Mailing Address - Phone:757-229-8920
Mailing Address - Fax:757-229-8923
Practice Address - Street 1:1769 JAMESTOWN RD
Practice Address - Street 2:SUITE B
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2368
Practice Address - Country:US
Practice Address - Phone:757-229-8920
Practice Address - Fax:757-229-8923
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010077841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice