| Coastal Dental Services, Pllc | |
|
5460 Brockie St Virginia Beach VA 23464-7737 | |
| (757) 965-5194 | |
| Not Available |
| Full Name | Coastal Dental Services, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5460 Brockie St, Virginia Beach, Virginia |
| Authorized Official Name and Position | Mark D Newman (PRESIDENT) |
| Authorized Official Contact | 7579655194 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Dental Services, Pllc 5460 Brockie St Virginia Beach VA 23464-7737 Ph: (757) 965-5194 | Coastal Dental Services, Pllc 5460 Brockie St Virginia Beach VA 23464-7737 Ph: (757) 965-5194 |
| NPI Number | 1114447703 |
|---|---|
| Provider Enumeration Date | 06/23/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114447703 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 0443000025 (Virginia) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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