Commonwealth Pediatric Dentistry, PLLC
Dentist, General Practice in Midlothian, VA. Organization (NPI-2).
NPI number1982140620
StatusActive
Last updated in NPPESJan 18, 2017
Details
- NPI
- 1982140620
- Entity type
- Organization (NPI-2)
- Legal business name
- Commonwealth Pediatric Dentistry, PLLC
- Organization subpart
- Yes
- Enumeration date
- Jan 18, 2017
- Last updated
- Jan 18, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
6661 Lake Harbour DrMidlothian, VA 23112-2082
Phone 804-363-4283
Mailing address
6661 Lake Harbour DrMidlothian, VA 23112-2082
Authorized official
Lauri Henderson
Administrative Assistant
8043634283
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