| Drs. Soderquist & Weis, P. C. | |
|
1101 E Jefferson St Charlottesville VA 22902-5353 | |
| (434) 971-9601 | |
| (434) 971-9646 |
| Full Name | Drs. Soderquist & Weis, P. C. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1101 E Jefferson St, Charlottesville, Virginia |
| Authorized Official Name and Position | Judy H Burruss (OFFICE MANAGER) |
| Authorized Official Contact | 4349719601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Drs. Soderquist & Weis, P. C. 1101 E Jefferson St Charlottesville VA 22902-5353 Ph: (434) 971-9601 | Drs. Soderquist & Weis, P. C. 1101 E Jefferson St Charlottesville VA 22902-5353 Ph: (434) 971-9601 |
| NPI Number | 1720093693 |
|---|---|
| Provider Enumeration Date | 07/29/2006 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720093693 | NPI | - | NPPES |
| 9178262 | Medicaid | VA | |
| 9178339 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | S4157/ W8596 (Virginia) | Primary |
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