# COMMONWEALTH OF VIRGINIA/STATE DEPARTMENT OF HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PENINSULA HEALTH CENTER-DENTAL CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538318175
- **Authorized official:** DR. DAVID H TRUMP M.D. (HEALTH DIRECTOR)
- **Authorized official phone:** (757) 594-7305

## Contact information

- **Practice address:** 416 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1927
- **Practice address phone:** (757) 594-7096
- **Practice address fax:** (757) 594-7449
- **Mailing address:** 416 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1927
- **Mailing address phone:** (757) 594-7096
- **Mailing address fax:** (757) 594-7449

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | 1223D0001X | VA | Yes |

## Other

- **Enumeration date:** 09/18/2008
- **Last updated:** 01/29/2009