Brickhouse, Tegwyn

Brickhouse, Tegwyn is an individual health care provider with primary practice located at 521 N 11Th St , Richmond VA 23298-5045. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Brickhouse, Tegwyn can be contacted via phone (804) 828-9095.

Contact Information

Primary practice address
521 N 11Th St Richmond VA 23298-5045
Phone: (804) 828-9095
Fax: (804) 827-1244
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 0411000034 Virginia

Profile Details

NPI number 1285664961
LBN Legal business name Brickhouse, Tegwyn
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Dec 14th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285664961 NPPES
Virginia MEDICAID 01-0025621
Virginia MEDICAID 0018308
Virginia Other 463655

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