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Organization

COURTHOUSE PEDIATRIC DENTISTRY PLLC

Active
Other names
Gloucester PD
Organization subpart
No

Provider details

NPI number
Authorized official
CHRIS L CANNON (RCM)
(804) 695-2575
Entity
Organization

Contact information

Practice address
6750 MAIN ST, GLOUCESTER, VA 23061-5517
(804) 695-2575
(804) 695-2815
Mailing address
6750 MAIN ST, GLOUCESTER, VA 23061-5517
(804) 695-2575
(804) 695-2815

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
04/29/2025
Last updated
04/29/2025
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