Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 0401004316 | VA |
NPI | 1003903733 |
---|---|
Provider Name | Dr. William Joseph Viglione |
First Address | Charlottesville, VA 22901-1456 |
Second Address | Charlottesville, VA 22901-1456 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9178834 | (05) | VA |