Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 0401415353 | VA |
NPI | 1093873762 |
---|---|
Provider Name | Dr. Sompop Bencharit |
First Address | Richmond, VA 23298-5064 |
Second Address | Richmond, VA 23298-5064 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 20/04/2020 |