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2145 S Military Hwy Chesapeake VA 23320-4426 | |
| (757) 545-5700 | |
| (757) 961-0471 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2145 S Military Hwy, Chesapeake, Virginia |
| Authorized Official Name and Position | Cathy Revell (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7575455700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2145 S Military Hwy Chesapeake VA 23320-4426 Ph: (757) 545-5700 | 2145 S Military Hwy Chesapeake VA 23320-4426 Ph: (757) 545-5700 |
| NPI Number | 1336566942 |
|---|---|
| Provider Enumeration Date | 03/20/2014 |
| Last Update Date | 04/28/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336566942 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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