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4722 N. Southside Plaza Ste #24 Richmond VA 23224 | |
(804) 319-5665 | |
(804) 319-5666 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 4722 N. Southside Plaza Ste #24, Richmond, Virginia |
Authorized Official Name and Position | Michelle Jacomino (DIRECTOR OF PAYOR RELATIONS) |
Authorized Official Contact | 7709165036 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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210 Interstate North Pkwy Se Ste 300 Atlanta GA 30339-2233 Ph: (770) 916-5028 | 4722 N. Southside Plaza Ste #24 Richmond VA 23224 Ph: (804) 319-5665 |
NPI Number | 1346335924 |
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Provider Enumeration Date | 10/03/2006 |
Last Update Date | 01/18/2024 |
Identifier | Type | State | Issuer |
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1346335924 | NPI | - | NPPES |
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