Organization
EAST COAST CENTRE FOR COSMETIC DENTISTRY AND FACIAL AESTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY LEROY CHICKEY DDS (PRESIDENT)
(757) 481-3305
Entity
Organization
Contact information
Practice address
3304 ARCTIC AVE, VIRGINIA BEACH, VA 23451-2913
(757) 481-3305
(757) 481-7157
Mailing address
3304 ARCTIC AVE, VIRGINIA BEACH, VA 23451-2913
(757) 481-3305
(757) 481-7157
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005366
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770586216
PERSONAL NPI NUMBER
—
Enumeration date
05/02/2018
Last updated
06/16/2018
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