Organization
SOUTHSIDE ORAL & FACIAL SURGERY
Active
Other names
Drs. O'Neill, Trotter & Brinser
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY SCOTT TROTTER D.D.S. (DENTIST)
(804) 717-5275
Entity
Organization
Contact information
Practice address
11971 IRON BRIDGE RD, CHESTER, VA 23831-1458
(804) 717-5275
(804) 748-4017
Mailing address
11971 IRON BRIDGE RD, CHESTER, VA 23831-1458
(804) 717-5275
(804) 748-4017
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4685
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005298
ANTHEM BC&BS
—
01
—
005299
ANTHEM BC&BS
—
01
—
219899
ANTHEM BC&BS
—
01
—
219900
ANTHEM BC&BS
—
01
—
259641
ANTHEM BC&BS
—
01
—
386682
ANTHEM BC&BS
—
01
—
386684
ANTHEM BC&BS
—
01
—
386686
ANTHEM BC&BS
—
05
—
9179952
—
VA
05
—
9185610
—
VA
05
—
9185611
—
VA
05
—
9202377
—
VA
Enumeration date
03/13/2008
Last updated
03/13/2008
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