Organization
PEDIATRIC DENTAL CARE OF VIRGINIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIEL MALCHIJAH BROWN DDS (PRESIDENT)
(540) 293-2289
Entity
Organization
Contact information
Practice address
5126 KING'S MOUNTAIN ROAD, COLLINSVILLE, VA 24078
(276) 647-2033
(276) 647-2034
Mailing address
5126 KING'S MOUNTAIN ROAD, COLLINSVILLE, VA 24078
(276) 647-2033
(276) 647-2034
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401410219
VA
Other
Enumeration date
05/04/2007
Last updated
08/22/2020
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