| Gainesville Pediatric Dentistry | |
|
7534 Limestone Dr Gainesville VA 20155-4005 | |
| (703) 754-1580 | |
| (703) 754-1897 |
| Full Name | Gainesville Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 7534 Limestone Dr, Gainesville, Virginia |
| Authorized Official Name and Position | Tina Perry (OFFICE MANAGER) |
| Authorized Official Contact | 7037541580 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gainesville Pediatric Dentistry 7534 Limestone Dr Gainesville VA 20155-4005 Ph: (703) 754-1580 | Gainesville Pediatric Dentistry 7534 Limestone Dr Gainesville VA 20155-4005 Ph: (703) 754-1580 |
| NPI Number | 1407030323 |
|---|---|
| Provider Enumeration Date | 12/27/2007 |
| Last Update Date | 12/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407030323 | NPI | - | NPPES |
| 10642 | Other | VA | DELTA |
| 107236 | Medicaid | VA | |
| 9178837 | Medicaid | VA | |
| 186586 | Other | VA | BCBS |
| 1580984 | Other | VA | UNITED CONCORDIA |
| 9179290 | Medicaid | VA | |
| 10803 | Other | VA | DELTA |
| 1753242 | Other | VA | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 0401410803 (Virginia) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | 0401410642 (Virginia) | Primary |
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