| Halifax Regional Dental Clinic | |
|
101 Aubreys Loop South Boston VA 24592-5056 | |
| (434) 517-8361 | |
| (434) 517-8367 |
| Full Name | Halifax Regional Dental Clinic |
|---|---|
| Speciality | Dentist |
| Location | 101 Aubreys Loop, South Boston, Virginia |
| Authorized Official Name and Position | Cecil Hazelwood (MANAGER DHG) |
| Authorized Official Contact | 4345173515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Halifax Regional Dental Clinic Po Box 860 South Boston VA 24592-0860 Ph: (434) 517-8361 | Halifax Regional Dental Clinic 101 Aubreys Loop South Boston VA 24592-5056 Ph: (434) 517-8361 |
| NPI Number | 1508110057 |
|---|---|
| Provider Enumeration Date | 11/06/2012 |
| Last Update Date | 11/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508110057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 0401412161 (Virginia) | Primary |
William D. Owen, Jr.,dds & Debra G. Claycomb,dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 431 Main St, South Boston, VA 24592 Phone: 434-572-3205 Fax: 434-572-8566 | |
Kwang W Kim, Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Mineral St, South Boston, VA 24592 Phone: 434-572-4928 Fax: 434-575-0302 |