Organization
CHILDRENS ENDODONTIC SERVICES, PC
Active
Other names
Dr. Paula Nesbitt
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAULA EVETTE NESBITT DDS MSD (OWNER)
(804) 733-6740
Entity
Organization
Contact information
Practice address
2010 WAKEFIELD AVE, PETERSBURG, VA 23805-2112
(804) 733-6740
(804) 733-8687
Mailing address
2010 WAKEFIELD AVE, PETERSBURG, VA 23805-2112
(804) 733-6740
(804) 733-8687
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
0401412670
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004708800
—
FL
01
—
0401412670
VIRGINIA DENTAL LICENSE
VA
05
—
1184607756
—
VA
05
—
3225803
—
TN
05
—
45003936
—
KY
01
—
5360
TENNESSEE DENTAL LICENSE
TN
05
—
60003308
—
KY
01
—
DEN1000852
WASHINGTON DC DENTAL LICENSE
DC
01
—
DN19669
FLORIDA LIMITED DENTAL LICENSE
FL
Enumeration date
04/06/2007
Last updated
11/07/2015
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