# NEIBAUER DENTAL CARE, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NEIBAUER DENTAL CARE, PC
- **Other names:** Neibauer Dental Care - Central Park
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1265709919
- **Legal business name:** NEIBAUER DENTAL CARE, PC
- **Authorized official:** KELLI WALKER (INSURANCE/CREDENTIALING)
- **Authorized official phone:** (217) 540-5100

## Contact information

- **Practice address:** 3128 COWAN BLVD, FREDERICKSBURG, VA 22401-4975
- **Practice address phone:** (540) 899-9511
- **Practice address fax:** (540) 786-1994
- **Mailing address:** 3128 COWAN BLVD, FREDERICKSBURG, VA 22401-4975
- **Mailing address phone:** (540) 899-9511
- **Mailing address fax:** (540) 786-1994

## Taxonomy

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

## Other

- **Enumeration date:** 11/23/2011
- **Last updated:** 11/23/2011