| Dr. Paula Nesbitt | |
|
2010 Wakefield Ave Petersburg VA 23805-2112 | |
| (804) 733-6740 | |
| (804) 733-8687 |
| Full Name | Dr. Paula Nesbitt |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 2010 Wakefield Ave, Petersburg, Virginia |
| Authorized Official Name and Position | Paula Evette Nesbitt (OWNER) |
| Authorized Official Contact | 8047336740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Paula Nesbitt 2010 Wakefield Ave Petersburg VA 23805-2112 Ph: (804) 733-6740 | Dr. Paula Nesbitt 2010 Wakefield Ave Petersburg VA 23805-2112 Ph: (804) 733-6740 |
| NPI Number | 1750403911 |
|---|---|
| Provider Enumeration Date | 04/06/2007 |
| Last Update Date | 11/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750403911 | NPI | - | NPPES |
| 3225803 | Medicaid | TN | |
| 5360 | Other | TN | TENNESSEE DENTAL LICENSE |
| DN19669 | Other | FL | FLORIDA LIMITED DENTAL LICENSE |
| 0401412670 | Other | VA | VIRGINIA DENTAL LICENSE |
| DEN1000852 | Other | DC | WASHINGTON DC DENTAL LICENSE |
| 004708800 | Medicaid | FL | |
| 1184607756 | Medicaid | VA | |
| 45003936 | Medicaid | KY | |
| 60003308 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 0401412670 (Virginia) | Primary |
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