# SEDP WAYNESBORO, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Waynesboro Blue Ridge Dental, Waynesboro Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205559929
- **Authorized official:** JALONDA SWEENEY (DIRECTOR)
- **Authorized official phone:** (704) 997-8878

## Contact information

- **Practice address:** 41 STONERIDGE DR, WAYNESBORO, VA 22980-6523
- **Practice address phone:** (540) 943-5211
- **Mailing address:** 19810 W CATAWBA AVE STE A1, CORNELIUS, NC 28031-4056
- **Mailing address phone:** (704) 997-8878

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/20/2022
- **Last updated:** 12/13/2022