Organization
PRIME ORTHODONTICS PLLC
Active
Parent organization
PRIME ORTHODONTICS
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIME ORTHODONTICS
Authorized official
CHRIS L CANNON (RCM)
(757) 327-4843
Entity
Organization
Contact information
Practice address
6750 MAIN ST, GLOUCESTER, VA 23061-5517
(757) 327-4843
(757) 234-8891
Mailing address
6750 MAIN ST, GLOUCESTER, VA 23061-5517
(757) 327-4843
(757) 234-8891
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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