Organization
JACK MAVROMATIS DDS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK MAVROMATIS JR. DDS (OWNER DENTIST)
(757) 496-9123
Entity
Organization
Contact information
Practice address
2248 SUNSTATES CT STE 103, VIRGINIA BEACH, VA 23451-1553
(757) 496-9123
(757) 496-2083
Mailing address
2248 SUNSTATES CT STE 103, VIRGINIA BEACH, VA 23451-1553
(757) 496-9123
(757) 496-2083
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/22/2007
Last updated
04/30/2012
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