| South Side Dental Center | |
|
1200 Five Springs Rd Ste 101 Charlottesville VA 22902-8756 | |
| (434) 984-8828 | |
| Not Available |
| Full Name | South Side Dental Center |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1200 Five Springs Rd Ste 101, Charlottesville, Virginia |
| Authorized Official Name and Position | Brad Spano (PRESIDENT) |
| Authorized Official Contact | 4349848828 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Side Dental Center 1200 Five Springs Rd Ste 101 Charlottesville VA 22902-8756 Ph: (434) 984-8828 | South Side Dental Center 1200 Five Springs Rd Ste 101 Charlottesville VA 22902-8756 Ph: (434) 984-8828 |
| NPI Number | 1437767670 |
|---|---|
| Provider Enumeration Date | 07/14/2020 |
| Last Update Date | 07/14/2020 |
| Certification Date | 07/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437767670 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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