Organization
COMMONWEALTH PEDIATRIC DENTAL SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOY PHELPS D.M.D. (PEDIATRIC DENTIST/OWNER)
(617) 875-6808
Entity
Organization
Contact information
Practice address
5506 WHITESIDE ROAD, SANDSTON, VA 23150-2345
(617) 875-6808
Mailing address
5506 WHITESIDE ROAD, SANDSTON, VA 23150-2345
(617) 875-6808
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
401411512
VA
Other
Enumeration date
10/31/2014
Last updated
10/31/2014
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