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2486 Pruden Blvd Suffolk VA 23434-4206 | |
| (757) 539-3021 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 2486 Pruden Blvd, Suffolk, Virginia |
| Authorized Official Name and Position | Steve A Gwaltney (DENTIST) |
| Authorized Official Contact | 7575393021 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2486 Pruden Blvd Suffolk VA 23434-4206 Ph: (757) 539-3021 | 2486 Pruden Blvd Suffolk VA 23434-4206 Ph: (757) 539-3021 |
| NPI Number | 1750833182 |
|---|---|
| Provider Enumeration Date | 11/02/2016 |
| Last Update Date | 11/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750833182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 0401006166 (Virginia) | Primary |
Trudeau Endodontics, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1510 Breezeport Way, Suite 400, Suffolk, VA 23435 Phone: 757-638-4500 | |
Robert E Anderson Dds Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2490 Pruden Boulevard, Suffolk, VA 23434 Phone: 757-934-3000 Fax: 757-934-1200 | |