Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 0401004501 | VA |
NPI | 1063425403 |
---|---|
Provider Name | Dr. David George Terrill |
First Address | Fredericksburg, VA 22407-5015 |
Second Address | Fredericksburg, VA 22407-5015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 08/07/2007 |