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Organization

CHILDRENS DENTAL WORLD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELE GAY (RECEPTIONIST)
(757) 337-0451
Entity
Organization

Contact information

Practice address
6224 PORTSMOUTH BLVD, SUITE 300, PORTSMOUTH, VA 23701-1351
(757) 337-0451
Mailing address
6224 PORTSMOUTH BLVD, SUITE 300, PORTSMOUTH, VA 23701-1351

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401412222
VA

Other

Enumeration date
07/17/2008
Last updated
07/17/2008
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