Provider Demographics
NPI:1740731454
Name:WOODLAKE FAMILY DENTISTRY
Entity type:Organization
Organization Name:WOODLAKE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CURT
Authorized Official - Middle Name:
Authorized Official - Last Name:KILLAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-739-4194
Mailing Address - Street 1:6540 WOODLAKE VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2200
Mailing Address - Country:US
Mailing Address - Phone:804-739-4194
Mailing Address - Fax:
Practice Address - Street 1:6540 WOODLAKE VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2200
Practice Address - Country:US
Practice Address - Phone:804-739-4194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL VIRGINIA DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty