| Gloucester PD | |
|
6750 Main St Gloucester VA 23061-5517 | |
| (804) 695-2575 | |
| (804) 695-2815 |
| Full Name | Gloucester PD |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6750 Main St, Gloucester, Virginia |
| Authorized Official Name and Position | Chris L Cannon (RCM) |
| Authorized Official Contact | 8046952575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gloucester PD 6750 Main St Gloucester VA 23061-5517 Ph: (804) 695-2575 | Gloucester PD 6750 Main St Gloucester VA 23061-5517 Ph: (804) 695-2575 |
| NPI Number | 1790573731 |
|---|---|
| Provider Enumeration Date | 04/29/2025 |
| Last Update Date | 04/29/2025 |
| Certification Date | 04/29/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790573731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
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