Provider Demographics
NPI:1447792155
Name:ADRIAN C AVRAM, DDS,PLLC
Entity Type:Organization
Organization Name:ADRIAN C AVRAM, DDS,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIS/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:CALIN
Authorized Official - Last Name:AVRAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-740-0834
Mailing Address - Street 1:1006 PUMP RD STE 101
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23238-5540
Mailing Address - Country:US
Mailing Address - Phone:804-740-0834
Mailing Address - Fax:
Practice Address - Street 1:1006 PUMP RD STE 101
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23238-5540
Practice Address - Country:US
Practice Address - Phone:804-920-9281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL VIRGINIA DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-11
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014129151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty