Provider Demographics
NPI:1891260923
Name:D & D FAMILY DENTISTRY, PC
Entity Type:Organization
Organization Name:D & D FAMILY DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-276-4555
Mailing Address - Street 1:6935 HULL STREET RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23224-2547
Mailing Address - Country:US
Mailing Address - Phone:804-276-4555
Mailing Address - Fax:804-859-2938
Practice Address - Street 1:6935 HULL STREET RD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23224-2547
Practice Address - Country:US
Practice Address - Phone:804-276-4555
Practice Address - Fax:804-859-2938
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:D & D FAMILY DENTISTRY, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty