Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 0401417460 | VA |
NPI | 1124378260 |
---|---|
Provider Name | Dr. Ana Cristina Couto Hack Caldeira De Andrada |
First Address | Richmond, VA 23298-5064 |
Second Address | Richmond, VA 23298-5064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2012 |
Last Update Date | 22/09/2021 |