# SOUTHSIDE DENTAL CARES, PC

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

## Provider details

- **NPI number:** 1962154252
- **Authorized official:** MRS. BARBARA HEPNER (MANAGER)
- **Authorized official phone:** (804) 290-8001

## Contact information

- **Practice address:** 2731 S CRATER RD, PETERSBURG, VA 23805-2403
- **Practice address phone:** (804) 732-8557
- **Mailing address:** 5231 HICKORY PARK DR STE E, GLEN ALLEN, VA 23059-2619
- **Mailing address phone:** (804) 290-8001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/19/2022
- **Last updated:** 01/19/2022