Pediatric Dentistry & Orthodontics Of Va, PC
Dentist, General Practice in Midlothian, VA. Organization (NPI-2).
NPI number1124579396
StatusActive
Last updated in NPPESDec 12, 2023
Details
- NPI
- 1124579396
- Entity type
- Organization (NPI-2)
- Legal business name
- Pediatric Dentistry & Orthodontics Of Va, PC
- Organization subpart
- Yes
- Enumeration date
- Oct 21, 2016
- Last updated
- Dec 12, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
| 1223P0221X | Dentist, Pediatric Dentistry | – | – | |
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | – | – |
Practice location
13463 Hull Street Rd.Midlothian, VA 23112-2103
Phone 804-739-0963 · Fax 804-739-0965
Mailing address
13463 Hull Street Rd.Midlothian, VA 23112-2103
Phone 804-739-0963 · Fax 804-739-0965
Authorized official
Steven R. Lubbe
Vice President
8047390963
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