# DRS BUSSEY MAYO ARCHER LTD

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

## Provider details

- **NPI number:** 1689754277
- **Authorized official:** MS. SHANDALE MARIE GREGORY (BILLING FINANCIAL COORDINATOR)
- **Authorized official phone:** (757) 486-5155

## Contact information

- **Practice address:** 2995 CHURCHLAND BLVD, CHESAPEAKE, VA 23321
- **Practice address phone:** (757) 483-2167
- **Practice address fax:** (757) 483-9320
- **Mailing address:** 2995 CHURCHLAND BLVD, CHESAPEAKE, VA 23321
- **Mailing address phone:** (757) 483-2167
- **Mailing address fax:** (757) 483-9320

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 0401004066 | VA | Yes |
| 1223E0200X | Endodontics | 0401007693 | VA | — |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 08/22/2020