| Marybeth Fasano Dmd Pc | |
|
984 First Colonial Rd Suite 200 Virginia Beach VA 23454-3196 | |
| (757) 412-2235 | |
| (757) 412-2237 |
| Full Name | Marybeth Fasano Dmd Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 984 First Colonial Rd, Virginia Beach, Virginia |
| Authorized Official Name and Position | Shana D Randolph (INSURANCE/FINANCIAL COORDINATOR) |
| Authorized Official Contact | 7574122235 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marybeth Fasano Dmd Pc 984 First Colonial Rd Suite 200 Virginia Beach VA 23454-3196 Ph: (757) 412-2235 | Marybeth Fasano Dmd Pc 984 First Colonial Rd Suite 200 Virginia Beach VA 23454-3196 Ph: (757) 412-2235 |
| NPI Number | 1194905539 |
|---|---|
| Provider Enumeration Date | 11/13/2007 |
| Last Update Date | 11/13/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194905539 | NPI | - | NPPES |
| 980759 | Other | VA | UNITED CONCORDIA |
| 153899 | Other | VA | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 0401008908 (Virginia) | Primary |
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