Pungoteague Elementary School Dental Program | |
28480 Bobtown Rd Melfa VA 23410-3508 | |
(757) 789-7777 | |
(757) 789-7778 |
Full Name | Pungoteague Elementary School Dental Program |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 28480 Bobtown Rd, Melfa, Virginia |
Authorized Official Name and Position | Jeannette Edwards (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 7574140400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Pungoteague Elementary School Dental Program 20280 Market St Onancock VA 23417-1331 Ph: (757) 414-0400 | Pungoteague Elementary School Dental Program 28480 Bobtown Rd Melfa VA 23410-3508 Ph: (757) 789-7777 |
NPI Number | 1881847135 |
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Provider Enumeration Date | 10/30/2008 |
Last Update Date | 03/22/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881847135 | NPI | - | NPPES |
008450552 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |