Pediatric Dental Specialists Pllc | |
213 Bulifants Blvd Ste B Williamsburg VA 23188-5733 | |
(866) 977-4787 | |
Not Available |
Full Name | Pediatric Dental Specialists Pllc |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 213 Bulifants Blvd Ste B, Williamsburg, Virginia |
Authorized Official Name and Position | Rana Denise Graham-montaqe (OWNER/PEDIATRIC DENTIST) |
Authorized Official Contact | 8669774787 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Pediatric Dental Specialists Pllc 213 Bulifants Blvd Ste B Williamsburg VA 23188-5733 Ph: (866) 977-4787 | Pediatric Dental Specialists Pllc 213 Bulifants Blvd Ste B Williamsburg VA 23188-5733 Ph: (866) 977-4787 |
NPI Number | 1265782361 |
---|---|
Provider Enumeration Date | 09/16/2012 |
Last Update Date | 09/16/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265782361 | NPI | - | NPPES |
11505 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 0401411505 (Virginia) | Primary |
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