| Commonwealth Dentistry - Chesapeake | |
|
4107 Portsmouth Blvd Ste 107 Chesapeake VA 23321-2140 | |
| (757) 488-3392 | |
| Not Available |
| Full Name | Commonwealth Dentistry - Chesapeake |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4107 Portsmouth Blvd Ste 107, Chesapeake, Virginia |
| Authorized Official Name and Position | Michael Riccobene (CEO) |
| Authorized Official Contact | 9108536172 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Dentistry - Chesapeake Po Box 749632 Atlanta GA 30374-9632 Ph: (757) 488-3392 | Commonwealth Dentistry - Chesapeake 4107 Portsmouth Blvd Ste 107 Chesapeake VA 23321-2140 Ph: (757) 488-3392 |
| NPI Number | 1750060679 |
|---|---|
| Provider Enumeration Date | 07/17/2023 |
| Last Update Date | 08/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750060679 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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