Provider Demographics
NPI:1053771634
Name:JOSEPH W ELROD JR DDS
Entity type:Organization
Organization Name:JOSEPH W ELROD JR DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:ELROD
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-746-1300
Mailing Address - Street 1:7516 RIGHT FLANK RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-3827
Mailing Address - Country:US
Mailing Address - Phone:804-746-1300
Mailing Address - Fax:804-730-4149
Practice Address - Street 1:7516 RIGHT FLANK RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-3827
Practice Address - Country:US
Practice Address - Phone:804-746-1300
Practice Address - Fax:804-730-4149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty