# PEDIATRIC DENTAL SPECIALISTS OF HAMPTON

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

## Provider details

- **NPI number:** 1720520794
- **Authorized official:** DR. RANA D GRAHAM-MONTAQUE DDS (OWNER/PEDIATRIC DENTIST)
- **Authorized official phone:** (804) 640-8545

## Contact information

- **Practice address:** 2111 HARTFORD RD, HAMPTON, VA 23666-2576
- **Practice address phone:** (757) 903-4525
- **Mailing address:** 213 BULIFANTS BLVD STE B, WILLIAMSBURG, VA 23188-5733
- **Mailing address phone:** (757) 903-4525

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 0401411505 | VA | Yes |

## Other

- **Enumeration date:** 11/08/2016
- **Last updated:** 11/08/2016