Pediatric Dental Care Of Tidewater Pc | |
5915 High Street West Portsmouth VA 23703 | |
(757) 484-8262 | |
(757) 638-3632 |
Full Name | Pediatric Dental Care Of Tidewater Pc |
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Speciality | Dentist - Pediatric Dentistry |
Location | 5915 High Street West, Portsmouth, Virginia |
Authorized Official Name and Position | Morgan Trey Weis (OWNER) |
Authorized Official Contact | 7574848262 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Pediatric Dental Care Of Tidewater Pc 5915 High St W Portsmouth VA 23703-4505 Ph: (757) 484-8262 | Pediatric Dental Care Of Tidewater Pc 5915 High Street West Portsmouth VA 23703 Ph: (757) 484-8262 |
NPI Number | 1891915112 |
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Provider Enumeration Date | 04/27/2007 |
Last Update Date | 01/03/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891915112 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 0401410496 (Virginia) | Primary |
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