| Petersburg Complete Dental Care Pllc | |
|
23 Goodrich Ave Petersburg VA 23805-2119 | |
| (804) 861-5237 | |
| Not Available |
| Full Name | Petersburg Complete Dental Care Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 23 Goodrich Ave, Petersburg, Virginia |
| Authorized Official Name and Position | Susan E St. George (OWNER) |
| Authorized Official Contact | 8048615237 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Petersburg Complete Dental Care Pllc 23 Goodrich Ave Petersburg VA 23805-2119 Ph: (804) 861-5237 | Petersburg Complete Dental Care Pllc 23 Goodrich Ave Petersburg VA 23805-2119 Ph: (804) 861-5237 |
| NPI Number | 1770824435 |
|---|---|
| Provider Enumeration Date | 03/06/2013 |
| Last Update Date | 05/07/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770824435 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401412498 (Virginia) | Primary |
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