Provider Demographics
NPI:1215186408
Name:AVILES, FRANCISCO (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:
Last Name:AVILES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:FRANCISCO
Other - Middle Name:A
Other - Last Name:AVILES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, PC
Mailing Address - Street 1:2125 MCCOMAS WAY STE 105
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-3986
Mailing Address - Country:US
Mailing Address - Phone:757-570-0404
Mailing Address - Fax:888-483-3335
Practice Address - Street 1:2125 MCCOMAS WAY STE 105
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-3986
Practice Address - Country:US
Practice Address - Phone:757-570-0404
Practice Address - Fax:888-483-3335
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014130071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice