Brush Up Dental PC
Preferred Provider Organization in Richmond, VA. Organization (NPI-2).
NPI number1366818841
StatusActive
Last updated in NPPESAug 19, 2015
Details
- NPI
- 1366818841
- Entity type
- Organization (NPI-2)
- Legal business name
- Brush Up Dental PC
- Organization subpart
- No
- Enumeration date
- Aug 19, 2015
- Last updated
- Aug 19, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305R00000X | Preferred Provider Organization | 0401410585 | VA | Yes |
Practice location
7000 Forest Ave#800
Richmond, VA 23230
Phone 804-673-5280
Mailing address
7000 Forest Ave#800
Richmond, VA 23230
Phone 804-673-5280
Authorized official
Jason T Lipscomb
Dentist
8049864058
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