Provider Demographics
NPI:1891289195
Name:FLORES, PATRICIA A (DDS)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:FLORES
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 1:205 GLYNN SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2825
Mailing Address - Country:US
Mailing Address - Phone:561-901-2858
Mailing Address - Fax:
Practice Address - Street 1:4939 COURTHOUSE ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2687
Practice Address - Country:US
Practice Address - Phone:757-259-0741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014160671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice