| Toothbeary Pediatric Dentistry | |
|
4300 Pouncey Tract Road Suite I Glen Allen VA 23060 | |
| (804) 709-8166 | |
| Not Available |
| Full Name | Toothbeary Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4300 Pouncey Tract Road Suite I, Glen Allen, Virginia |
| Authorized Official Name and Position | Darchelle Braxton (PEDIATRIC DENTIST) |
| Authorized Official Contact | 8047098166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Toothbeary Pediatric Dentistry 4300 Pouncey Tract Road Suite I Glen Allen VA 23060 Ph: (804) 709-8166 | Toothbeary Pediatric Dentistry 4300 Pouncey Tract Road Suite I Glen Allen VA 23060 Ph: (804) 709-8166 |
| NPI Number | 1265889570 |
|---|---|
| Provider Enumeration Date | 05/17/2016 |
| Last Update Date | 05/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265889570 | NPI | - | NPPES |
| 03647894 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 0401414243 (Virginia) | Primary |
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