Organization
IDEAL FAMILY DENTISTRY LLC
Active
Other names
Ideal Family Dentistry LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE LOPEZ (PRACTICE MANAGER)
(804) 803-9823
Entity
Organization
Contact information
Practice address
3501 COURTHOUSE RD, NORTH CHESTERFIELD, VA 23236-1436
(804) 406-9595
(804) 946-1600
Mailing address
3501 COURTHOUSE RD, NORTH CHESTERFIELD, VA 23236-1436
(804) 406-9595
(804) 946-1600
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/07/2024
Last updated
08/09/2024
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