Provider Demographics
NPI:1184892358
Name:NANCE, GEORGE LAWRENCE JR (DDS MSD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:LAWRENCE
Last Name:NANCE
Suffix:JR
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 DENBIGH BLVD
Mailing Address - Street 2:SUITE 805
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608
Mailing Address - Country:US
Mailing Address - Phone:757-872-0617
Mailing Address - Fax:757-872-0767
Practice Address - Street 1:608 DENBIGH BLVD
Practice Address - Street 2:SUITE 805
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608
Practice Address - Country:US
Practice Address - Phone:757-872-0617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010049071223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics