Hampton Roads Pediatric Dentistry and Orthodontics, Pllc
NPI #1639542814 in Gloucester, Virginia
Provider Information
- NPI Number
- 1639542814
- Entity Type
- Organization
- Organization Name
- Hampton Roads Pediatric Dentistry and Orthodontics, Pllc
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- HAMPTON ROADS PEDIATRIC DENTISTRY AND ORTHODONTICS, PLLC
- Primary Specialty
- Dentist - Pediatric Dentistry
- Enumeration Date
- Nov 10, 2015
- Last Updated
- Apr 12, 2019
Practice Location
- Address
- 6882 MAIN ST
- City
- Gloucester
- State
- Virginia
- ZIP Code
- 23061-5163
- Phone
- (804) 695-2575
Authorized Official
- Name
- GRACE O DAVIS
- Title
- BUSINESS ADMINISTRATOR
- Phone
- (757) 369-1754
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics |
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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