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Organization
APPOMATTOX RIVER ORAL AND FACIAL SURGERY P.C.
Active
Organization
APPOMATTOX RIVER ORAL AND FACIAL SURGERY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT JOHN O'NEILL DDS MD (PRESIDENT)
(804) 732-6532
Entity
Organization
Contact information
Practice address
595 OLD WAGNER RD STE A, PETERSBURG, VA 23805-9307
(804) 732-6532
(804) 861-8070
Mailing address
595 OLD WAGNER RD STE A, PETERSBURG, VA 23805-9307
(804) 732-6532
(804) 861-8070
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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