Richard L Anthony, DDS

Individual provider Active NPI General Practice Dentistry · Blacksburg, VA

NPI 1386794725 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1386794725
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
0401008940 (VA)
Practice address
200 Professional Park Dr SE Ste 7
Blacksburg, VA 24060-6669
Phone
(540) 552-8870
Fax
(540) 552-7757
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0401008940VAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401008940 VA Yes

Addresses

Primary practice location

200 Professional Park Dr SE Ste 7
Blacksburg, VA 24060-6669

Mailing address

1207 Village Way S
Blacksburg, VA 24060-1795
Phone (540) 961-0909

Other providers in Blacksburg, VA

All providers in Blacksburg, VA · General Practice Dentistry in Virginia

Sources for this page

Verify at the official NPI Registry.