| Pediatric Dental Specialists Pllc | |
|
213 Bulifants Blvd Ste B Williamsburg VA 23188-5733 | |
| (866) 977-4787 | |
| Not Available |
| Full Name | Pediatric Dental Specialists Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 213 Bulifants Blvd Ste B, Williamsburg, Virginia |
| Authorized Official Name and Position | Rana Denise Graham-montaqe (OWNER/PEDIATRIC DENTIST) |
| Authorized Official Contact | 8669774787 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dental Specialists Pllc 213 Bulifants Blvd Ste B Williamsburg VA 23188-5733 Ph: (866) 977-4787 | Pediatric Dental Specialists Pllc 213 Bulifants Blvd Ste B Williamsburg VA 23188-5733 Ph: (866) 977-4787 |
| NPI Number | 1265782361 |
|---|---|
| Provider Enumeration Date | 09/16/2012 |
| Last Update Date | 09/16/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265782361 | NPI | - | NPPES |
| 11505 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 0401411505 (Virginia) | Primary |
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