Organization
COMMONWEALTH DENTAL ANESTHESIOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE CARNEY DDS, MS (PRESIDENT)
(434) 242-5446
Entity
Organization
Contact information
Practice address
1460-B PANTOPS MOUNTAIN PLACE, CHARLOTTESVILLE, VA 22911
(434) 242-5446
Mailing address
1460-B PANTOPS MOUNTAIN PLACE, CHARLOTTESVILLE, VA 22911
(434) 242-5446
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0401410463
VA
Other
Enumeration date
11/21/2013
Last updated
11/21/2013
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