# CHILDRENS ENDODONTIC SERVICES, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dr. Paula Nesbitt
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750403911
- **Authorized official:** DR. PAULA EVETTE NESBITT DDS MSD (OWNER)
- **Authorized official phone:** (804) 733-6740

## Contact information

- **Practice address:** 2010 WAKEFIELD AVE, PETERSBURG, VA 23805-2112
- **Practice address phone:** (804) 733-6740
- **Practice address fax:** (804) 733-8687
- **Mailing address:** 2010 WAKEFIELD AVE, PETERSBURG, VA 23805-2112
- **Mailing address phone:** (804) 733-6740
- **Mailing address fax:** (804) 733-8687

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 0401412670 | VA | Yes |

## Other

- **Enumeration date:** 04/06/2007
- **Last updated:** 11/07/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004708800 | — | FL |
| 01 | — | 0401412670 | VIRGINIA DENTAL LICENSE | VA |
| 05 | — | 1184607756 | — | VA |
| 05 | — | 3225803 | — | TN |
| 05 | — | 45003936 | — | KY |
| 01 | — | 5360 | TENNESSEE DENTAL LICENSE | TN |
| 05 | — | 60003308 | — | KY |
| 01 | — | DEN1000852 | WASHINGTON DC DENTAL LICENSE | DC |
| 01 | — | DN19669 | FLORIDA LIMITED DENTAL LICENSE | FL |