# PEDIATRIC DENTISTRY & ORTHODONTICS OF VA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CENTRAL VIRGINIA DENTAL CARE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1730627357
- **Legal business name:** CENTRAL VIRGINIA DENTAL CARE
- **Authorized official:** DR. DAVID L KEETON D.M.D. (MANAGER)
- **Authorized official phone:** (804) 739-0963

## Contact information

- **Practice address:** 13841 HULL STREET RD, SUITE 4, MIDLOTHIAN, VA 23112-2056
- **Practice address phone:** (804) 739-0963
- **Practice address fax:** (804) 739-0965
- **Mailing address:** 651 SOUTHPARK BLVD, COLONIAL HEIGHTS, VA 23834-3617
- **Mailing address phone:** (804) 536-9815
- **Mailing address fax:** (804) 526-9866

## Taxonomy

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

## Other

- **Enumeration date:** 02/02/2017
- **Last updated:** 02/02/2017