| Commonwealth Pediatric Dental Specialists | |
|
5506 Whiteside Road Sandston VA 23150-2345 | |
| (617) 875-6808 | |
| Not Available |
| Full Name | Commonwealth Pediatric Dental Specialists |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5506 Whiteside Road, Sandston, Virginia |
| Authorized Official Name and Position | Joy Phelps (PEDIATRIC DENTIST/OWNER) |
| Authorized Official Contact | 6178756808 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Pediatric Dental Specialists 5506 Whiteside Road Sandston VA 23150-2345 Ph: (617) 875-6808 | Commonwealth Pediatric Dental Specialists 5506 Whiteside Road Sandston VA 23150-2345 Ph: (617) 875-6808 |
| NPI Number | 1679978795 |
|---|---|
| Provider Enumeration Date | 10/31/2014 |
| Last Update Date | 10/31/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679978795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 401411512 (Virginia) | Primary |
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