Organization
GLADSTONE & SALERNO, DDS,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYRON DAVID GLADSTONE DDS (DENTIST)
(757) 424-3657
Entity
Organization
Contact information
Practice address
5318 PROVIDENCE RD, VIRGINIA BEACH, VA 23464-4102
(757) 424-3657
(757) 424-3451
Mailing address
5318 PROVIDENCE RD, VIRGINIA BEACH, VA 23464-4102
(757) 424-3657
(757) 424-3451
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4418 & 6630
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
094701
ANTHEM BC/BS
CA
01
—
817549
UNITED CONCORDIA
PA
Enumeration date
07/03/2006
Last updated
08/22/2020
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