# CHESAPEAKE FAMILY AND IMPLANT DENTISTRY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043717457
- **Authorized official:** MS. PATTY LYNN HEBERLING (OFFICE MANAGER)
- **Authorized official phone:** (757) 436-0026

## Contact information

- **Practice address:** CHESAPEAKE FAMILY AND IMPLANT DENTISTRY, 516 INNOVATION DR. SUITE 302, CHESAPEAKE, VA 23320
- **Practice address phone:** (757) 436-0026
- **Practice address fax:** (757) 547-5658
- **Mailing address:** CHESAPEAKE FAMILY AND IMPLANT DENTISTRY LLC, 516 INNOVATION DR. SUITE 302, CHESAPEAKE, VA 23320
- **Mailing address phone:** (757) 436-0026
- **Mailing address fax:** (757) 547-5658

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401006063 | VA | Yes |
| 305R00000X | Preferred Provider Organization | 0401006063 | VA | — |

## Other

- **Enumeration date:** 04/11/2018
- **Last updated:** 08/28/2018