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Organization

CHESAPEAKE FAMILY DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. OSAMA S MODJADIDI DMD (OWNER)
(757) 548-5619
Entity
Organization

Contact information

Practice address
113 GAINSBOROUGH SQ, SUITE 101, CHESAPEAKE, VA 23320-1713
(757) 548-5619
(757) 548-6930
Mailing address
113 GAINSBOROUGH SQ, SUITE 101, CHESAPEAKE, VA 23320-1713
(757) 548-6930

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
10/30/2012
Last updated
10/30/2012
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