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501 21st St Virginia Beach VA 23451-4118 | |
| (757) 428-6656 | |
| (757) 428-3470 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 501 21st St, Virginia Beach, Virginia |
| Authorized Official Name and Position | Jane Ann Haley (OFFICE MANAGER) |
| Authorized Official Contact | 7574286656 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
501 21st St Virginia Beach VA 23451-4118 Ph: (757) 428-6656 | 501 21st St Virginia Beach VA 23451-4118 Ph: (757) 428-6656 |
| NPI Number | 1972554749 |
|---|---|
| Provider Enumeration Date | 05/15/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972554749 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Virginia) | Primary |
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