Tennessee Enhanced Dental Services LLC

NPI #1215015250 in Virginia Beach, Virginia

Provider Information

NPI Number: 1215015250
Entity Type: Organization
Organization Name: Tennessee Enhanced Dental Services LLC
Primary Specialty: Dentist
Enumeration Date: Nov 1, 2006
Last Updated: Jul 14, 2008

Practice Location

Address: 1301 FIRST COLONIAL BLVD
City: Virginia Beach
State: Virginia
ZIP Code: 23454
Phone: (757) 463-1500

Authorized Official

Name: DR. JEFFREY RANDALL LEIDY, DMD
Title: PRESIDENT OWNER
Phone: (757) 463-1500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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