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Individual

DR. PHILIP JOSEPH RENDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
7198 CHAPMAN DR, SUITE 7, HAYES, VA 23072-3416
(804) 684-9971
(804) 642-2097
Mailing address
125 LAYDON WAY, POQUOSON, VA 23662-2243
(757) 868-7331
(804) 642-2097

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
VA0401008390
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106648
VA
01
8390
DELTA PROVIDER
VA
01
970780
UNITED CONCORDIA PROVIDER
VA
01
VA0401008390
STATE OF VA LICENSE #
VA
Enumeration date
08/30/2006
Last updated
03/07/2023
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