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Organization
DAVID B PEMBERTON DDS PC
Active
Organization
DAVID B PEMBERTON DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID B PEMBERTON DDS (DOCTOR OF DENTAL SURGERY)
(804) 233-6811
Entity
Organization
Contact information
Practice address
101 COWARDIN AVENUE, SUITE 303, RICHMOND, VA 23224
(804) 233-6811
(804) 230-0980
Mailing address
101 COWARDIN AVENUE, SUITE 303, RICHMOND, VA 23224
(804) 233-6811
(804) 230-0980
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005552
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00762638
UNITED CONCORDIA
—
01
—
077681
ANTHEM
VA
01
—
172260
ANTHEM
VA
05
—
7815042
—
VA
Enumeration date
07/20/2006
Last updated
09/02/2010
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