Organization
PENINSULA PEDIATRIC DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE O DAVIS (BUSINESS ADMINISTRATOR)
(757) 369-1754
Entity
Organization
Contact information
Practice address
220 NAT TURNER BOULEVARD S, NEWPORT NEWS, VA 23606
(757) 240-5711
(757) 240-4939
Mailing address
220 NAT TURNER BOULEVARD S, NEWPORT NEWS, VA 23606
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401410912
VA
Other
Enumeration date
05/17/2007
Last updated
05/29/2019
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