Organization
HQ US ARMY DENTAL ACTIVITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA COLUCCI (CREDENTIALS COORDINATOR)
(757) 314-7944
Entity
Organization
Contact information
Practice address
577 STERNBURG AVENUE, NEWPORT NEWS, VA 23604-5311
(757) 314-7944
(757) 314-7942
Mailing address
577 STERNBERG AVE, FORT EUSTIS, VA 23604-1526
(757) 314-7944
(757) 314-7942
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN21180
FL
Other
Enumeration date
07/28/2015
Last updated
08/13/2015
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