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6033 Providence Rd Virginia Beach VA 23464-3815 | |
| (757) 424-2672 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 6033 Providence Rd, Virginia Beach, Virginia |
| Authorized Official Name and Position | Laura Shawver (PRACTICE MANAGER) |
| Authorized Official Contact | 7574242672 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6033 Providence Rd Virginia Beach VA 23464-3815 Ph: (757) 424-2672 | 6033 Providence Rd Virginia Beach VA 23464-3815 Ph: (757) 424-2672 |
| NPI Number | 1265929913 |
|---|---|
| Provider Enumeration Date | 04/18/2018 |
| Last Update Date | 04/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265929913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Virginia) | Primary |
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