| Virginia Center For Advanced Dentistry, Brandermill Llc | |
|
2330 Colony Crossing Pl Midlothian VA 23112-4280 | |
| (804) 639-8338 | |
| (804) 639-9973 |
| Full Name | Virginia Center For Advanced Dentistry, Brandermill Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2330 Colony Crossing Pl, Midlothian, Virginia |
| Authorized Official Name and Position | Deepa Simon (PARTNER) |
| Authorized Official Contact | 8046398338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia Center For Advanced Dentistry, Brandermill Llc 2330 Colony Crossing Pl Midlothian VA 23112-4280 Ph: (804) 639-8338 | Virginia Center For Advanced Dentistry, Brandermill Llc 2330 Colony Crossing Pl Midlothian VA 23112-4280 Ph: (804) 639-8338 |
| NPI Number | 1932549110 |
|---|---|
| Provider Enumeration Date | 07/02/2013 |
| Last Update Date | 07/02/2013 |
| Medicare PECOS PAC ID | 1557664398 |
|---|---|
| Medicare Enrollment ID | O20160128000288 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932549110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Alexander Manuel Simon |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1770701948 PECOS PAC ID: 2466755202 Enrollment ID: I20160128000498 |
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