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2248 Sunstates Ct Ste 103 Virginia Beach VA 23451-1553 | |
| (757) 496-9123 | |
| (757) 496-2083 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 2248 Sunstates Ct Ste 103, Virginia Beach, Virginia |
| Authorized Official Name and Position | Jack Mavromatis (DENTIST) |
| Authorized Official Contact | 7574969123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2248 Sunstates Ct Ste 103 Virginia Beach VA 23451-1553 Ph: (757) 496-9123 | 2248 Sunstates Ct Ste 103 Virginia Beach VA 23451-1553 Ph: (757) 496-9123 |
| NPI Number | 1467798603 |
|---|---|
| Provider Enumeration Date | 12/17/2012 |
| Last Update Date | 12/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467798603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 0401006411 (Virginia) | Primary |
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