Organization
COMMONWEALTH OF VIRGINIA/STATE DEPARTMENT OF HEALTH
Active
Other names
PENINSULA HEALTH CENTER-DENTAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID H TRUMP M.D. (HEALTH DIRECTOR)
(757) 594-7305
Entity
Organization
Contact information
Practice address
416 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1927
(757) 594-7096
(757) 594-7449
Mailing address
416 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1927
(757) 594-7096
(757) 594-7449
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
1223D0001X
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4975103
—
VA
Enumeration date
09/18/2008
Last updated
01/29/2009
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