# APPOMATTOX RIVER ORAL AND FACIAL SURGERY P.C.

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

## Provider details

- **NPI number:** 1255007266
- **Authorized official:** DR. ROBERT JOHN O'NEILL DDS MD (PRESIDENT)
- **Authorized official phone:** (804) 732-6532

## Contact information

- **Practice address:** 595 OLD WAGNER RD STE A, PETERSBURG, VA 23805-9307
- **Practice address phone:** (804) 732-6532
- **Practice address fax:** (804) 861-8070
- **Mailing address:** 595 OLD WAGNER RD STE A, PETERSBURG, VA 23805-9307
- **Mailing address phone:** (804) 732-6532
- **Mailing address fax:** (804) 861-8070

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 08/19/2021
- **Last updated:** 08/19/2021