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Organization
MICHAEL EDENFIELD, DDS PC
Active
Organization
MICHAEL EDENFIELD, DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLA J PISMENY (PRACTICE ADMINISTRATOR)
(757) 488-1285
Entity
Organization
Contact information
Practice address
6263 PORTSMOUTH BLVD, PORTSMOUTH, VA 23701-1344
(757) 488-1285
(757) 465-9132
Mailing address
6263 PORTSMOUTH BLVD, PORTSMOUTH, VA 23701-1344
(757) 488-1285
(757) 465-9132
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0401008978
VA
Other
Enumeration date
07/20/2011
Last updated
07/20/2011
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