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10331 Memory Lane Chesterfield VA 23832 | |
| (804) 748-6677 | |
| (804) 748-7080 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 10331 Memory Lane, Chesterfield, Virginia |
| Authorized Official Name and Position | Sherry S Dodson-gordon (PRESIDENT) |
| Authorized Official Contact | 8047486677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
10331 Memory Lane Chesterfield VA 23832 Ph: (804) 748-6677 | 10331 Memory Lane Chesterfield VA 23832 Ph: (804) 748-6677 |
| NPI Number | 1740291913 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740291913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 0401007355 (Virginia) | Primary |
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