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Individual

DR. PHILIP JOSEPH PANDOLFI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
300 CENTRAL AVE, FORT GREGG ADAMS, VA 23801-1526
(804) 734-5454
Mailing address
300 CENTRAL AVE, FORT GREGG ADAMS, VA 23801-1526
(804) 734-5454

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401007043
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
139547
ANTHEM
VA
Enumeration date
12/19/2006
Last updated
07/10/2023
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