Provider Demographics
NPI:1710232020
Name:ROBERT W BIGELOW DDS PLLC
Entity Type:Organization
Organization Name:ROBERT W BIGELOW DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:BIGELOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-741-7440
Mailing Address - Street 1:5700 OLD RICHMOND AVE
Mailing Address - Street 2:SUITE A4
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1828
Mailing Address - Country:US
Mailing Address - Phone:804-741-7440
Mailing Address - Fax:804-288-1034
Practice Address - Street 1:5700 OLD RICHMOND AVE
Practice Address - Street 2:SUITE A4
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1828
Practice Address - Country:US
Practice Address - Phone:804-741-7440
Practice Address - Fax:804-288-1034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0401412488261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental