Provider Demographics
NPI:1790432102
Name:CENTRAL VALLEY ORAL AND FACIAL SURGERY, PLC
Entity Type:Organization
Organization Name:CENTRAL VALLEY ORAL AND FACIAL SURGERY, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:QUITMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-433-1751
Mailing Address - Street 1:2031 LEGACY LN
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8067
Mailing Address - Country:US
Mailing Address - Phone:540-433-1751
Mailing Address - Fax:540-433-1756
Practice Address - Street 1:2031 LEGACY LN
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:VA
Practice Address - Zip Code:22801-8067
Practice Address - Country:US
Practice Address - Phone:540-443-1751
Practice Address - Fax:540-433-1756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-05
Last Update Date:2022-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty