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5833 Harbour View Blvd Suite A Suffolk VA 23435-2657 | |
| (757) 686-3955 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 5833 Harbour View Blvd, Suffolk, Virginia |
| Authorized Official Name and Position | Mia Turner (PRACTICE COORDINATOR) |
| Authorized Official Contact | 7576863955 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5833 Harbour View Blvd Suite A Suffolk VA 23435-2657 Ph: (757) 686-3955 | 5833 Harbour View Blvd Suite A Suffolk VA 23435-2657 Ph: (757) 686-3955 |
| NPI Number | 1366628182 |
|---|---|
| Provider Enumeration Date | 01/10/2008 |
| Last Update Date | 01/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366628182 | NPI | - | NPPES |
| 9180412 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 0401411138 (Virginia) | Primary |
Trudeau Endodontics, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1510 Breezeport Way, Suite 400, Suffolk, VA 23435 Phone: 757-638-4500 | |
Robert E Anderson Dds Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2490 Pruden Boulevard, Suffolk, VA 23434 Phone: 757-934-3000 Fax: 757-934-1200 | |