Organization
DRS BUSSEY MAYO ARCHER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANDALE MARIE GREGORY (BILLING FINANCIAL COORDINATOR)
(757) 486-5155
Entity
Organization
Contact information
Practice address
2995 CHURCHLAND BLVD, CHESAPEAKE, VA 23321
(757) 483-2167
(757) 483-9320
Mailing address
2995 CHURCHLAND BLVD, CHESAPEAKE, VA 23321
(757) 483-2167
(757) 483-9320
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
0401004066
VA
1223E0200X
Endodontics
0401007693
VA
Other
Enumeration date
10/17/2006
Last updated
08/22/2020
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