Organization
SPOTSYLVANIA ORAL SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA MOODY (REGIONAL MANAGER)
(540) 710-6000
Entity
Organization
Contact information
Practice address
10406 COURTHOUSE RD, SPOTSYLVANIA, VA 22553-1712
(540) 898-7645
Mailing address
10406 COURTHOUSE RD, SPOTSYLVANIA, VA 22553-1712
(540) 898-7645
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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