| Commonwealth Oral & Facial Surgery, Pc | |
|
8503 Patterson Ave Suite B Richmond VA 23229-6442 | |
| (804) 354-1600 | |
| (804) 354-1607 |
| Full Name | Commonwealth Oral & Facial Surgery, Pc |
|---|---|
| Speciality | Dentist |
| Location | 8503 Patterson Ave, Richmond, Virginia |
| Authorized Official Name and Position | Gwen Eva Kennon (SENIOR BILLING SPECIALIST) |
| Authorized Official Contact | 8043541602 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Oral & Facial Surgery, Pc Po Box 71930 Richmond VA 23255-1930 Ph: (804) 354-1600 | Commonwealth Oral & Facial Surgery, Pc 8503 Patterson Ave Suite B Richmond VA 23229-6442 Ph: (804) 354-1600 |
| NPI Number | 1144274382 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 02/20/2019 |
| Medicare PECOS PAC ID | 0749282853 |
|---|---|
| Medicare Enrollment ID | O20070202000069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144274382 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 0135583-3 (Virginia) | Primary |
| Provider Name | Thomas E Eschenroeder |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1063462869 PECOS PAC ID: 3971505082 Enrollment ID: I20100428000936 |
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