Jesserwallddspa is a Dentist in Danville, Virginia. Jesserwallddspa practices all healthcare services and medical treatments related to Dentist. The NPI Number for Jesserwallddspa is 1104090067. The last update date is 2008-04-22.
Jesserwallddspa's current location address is 1045 Main St, Danville, Virginia. You can contact this provider via phone number 4347928622. The mailing address for Jesserwallddspa is 1045 Main St, Danville, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Jesserwallddspa |
|---|---|
| Address | 1045 Main St, Danville, Virginia |
| Phone Number | 4347928622 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Wall Jesse |
| Credentials | DDS |
| Telephone Number | 4347921512 |
NPI Number Detail
| NPI Number | 1104090067 |
|---|---|
| Provider Enumeration Date | 2008-04-22 |
| Last Updated Date | 2008-04-22 |
Provider Mailing Address Detail
| Address | 1045 Main St |
|---|---|
| City | Danville |
| State | Virginia (VA) |
| Post Code | 245411800 |
| Phone Number | 4347928622 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 5098 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5098 | VA | VA BOARDOF DENTISTRY |
Post Comment/ Review Below
What is the Jesserwallddspa's 1104090067?
The Jesserwallddspa's NPI (National Provider Identifier) Number is 1104090067. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Jesserwallddspa is physically located?
The Jesserwallddspa is situated at the following address: 1045 Main St, Danville, VA 245411800.
What is Jesserwallddspa's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Jesserwallddspa is Dentist, and the corresponding taxonomy classification code for this specialized field is 122300000X.
When did Jesserwallddspa receive its 1104090067 assignment?
The Jesserwallddspa was assigned its 1104090067 on 2008-04-22, which is the date when this unique identifier was issued to the organization.
When was the information related to Jesserwallddspa most recently updated or refreshed?
The details pertaining to the Jesserwallddspa, including its address, specialty, and other relevant information, were last updated or refreshed on 2008-04-22.