Organization
CD VIRGINIA DENTAL, P.C.
Active
Other names
General & Implant Dentistry of Tidewater
Organization subpart
No
Provider details
NPI number
Authorized official
TY JUSTICE (DIRECTOR, PAYER RELATIONS)
(513) 808-4984
Entity
Organization
Contact information
Practice address
836 FIRST COLONIAL RD, VIRGINIA BEACH, VA 23451-6126
(757) 428-8747
(757) 422-8165
Mailing address
9825 KENWOOD RD STE 200, BLUE ASH, OH 45242-6252
(513) 609-4076
(513) 448-0511
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/27/2019
Last updated
03/07/2024
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