|
| |
|
1739 Jefferson Davis Hwy Stafford VA 22554-7213 | |
| (540) 288-2579 | |
| (540) 288-3796 |
| Full Name | |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 1739 Jefferson Davis Hwy, Stafford, Virginia |
| Authorized Official Name and Position | Jane Krakowsky (BUSINESS MANAGER) |
| Authorized Official Contact | 5408994797 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
608 Jackson St Fredericksburg VA 22401-5719 Ph: (540) 899-4797 | 1739 Jefferson Davis Hwy Stafford VA 22554-7213 Ph: (540) 288-2579 |
| NPI Number | 1629089750 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 08/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629089750 | NPI | - | NPPES |
| 104852 | Other | VA | DORAL |
| 144853 | Other | VA | ANTHEM-MILLER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | (* (Not Available)) | Primary |
Neibauer Dental Care, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1610 Publix Way Ste 120, Stafford, VA 22554 Phone: 540-779-0395 | |
Suite Tooth Pediatrics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1229 Garrisonville Rd, Stafford, VA 22556 Phone: 716-860-4238 | |
Sasan Ahmadiyar Dds & Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 385 Garrisonville Rd, Suite 108, Stafford, VA 22554 Phone: 540-657-7645 Fax: 540-657-1009 |