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Organization

PEDIATRIC DENTISTRY & ORTHODONTICS OF VA

Active
Parent organization
CENTRAL VIRGINIA DENTAL CARE
Organization subpart
Yes

Provider details

NPI number
Legal business name
CENTRAL VIRGINIA DENTAL CARE
Authorized official
DR. DAVID L KEETON D.M.D. (MANAGER)
(804) 739-0963
Entity
Organization

Contact information

Practice address
13841 HULL STREET RD, SUITE 4, MIDLOTHIAN, VA 23112-2056
(804) 739-0963
(804) 739-0965
Mailing address
651 SOUTHPARK BLVD, COLONIAL HEIGHTS, VA 23834-3617
(804) 536-9815
(804) 526-9866

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
02/02/2017
Last updated
02/02/2017
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