Provider Demographics
NPI:1619089372
Name:NESSAR, ALICE J WILHELM (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:J WILHELM
Last Name:NESSAR
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 1:11337 LUDGATE PL
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-1877
Mailing Address - Country:US
Mailing Address - Phone:804-937-8309
Mailing Address - Fax:
Practice Address - Street 1:11337 LUDGATE PL
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1877
Practice Address - Country:US
Practice Address - Phone:804-937-8309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014104601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice