Organization
PEDIATRIC DENTISTRY & ORTHODONTICS OF VA, PC
Active
Parent organization
CENTRAL VIRGINIA DENTAL CARE, P.L.C.-PEDIATRIC DENTISTRY & ORTHODONTIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL VIRGINIA DENTAL CARE, P.L.C.-PEDIATRIC DENTISTRY & ORTHODONTIC
Authorized official
STEVEN R. LUBBE D.M.D. (VICE PRESIDENT)
(804) 739-0963
Entity
Organization
Contact information
Practice address
13463 HULL STREET RD., MIDLOTHIAN, VA 23112-2103
(804) 739-0963
(804) 739-0965
Mailing address
13463 HULL STREET RD., MIDLOTHIAN, VA 23112-2103
(804) 739-0963
(804) 739-0965
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
10/21/2016
Last updated
12/12/2023
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