| Fun Park Pediatric Dentistry | |
|
1009 Centerbrooke Ln Ste 210 Suffolk VA 23434-8664 | |
| (757) 767-7275 | |
| Not Available |
| Full Name | Fun Park Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1009 Centerbrooke Ln Ste 210, Suffolk, Virginia |
| Authorized Official Name and Position | Olanrewaju Oye-somefun (PEDIATRIC DENTIST) |
| Authorized Official Contact | 7577677275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fun Park Pediatric Dentistry 1009 Centerbrooke Ln Ste 210 Suffolk VA 23434-8664 Ph: (757) 767-7275 | Fun Park Pediatric Dentistry 1009 Centerbrooke Ln Ste 210 Suffolk VA 23434-8664 Ph: (757) 767-7275 |
| NPI Number | 1043842214 |
|---|---|
| Provider Enumeration Date | 02/06/2020 |
| Last Update Date | 09/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043842214 | NPI | - | NPPES |
| 0401416127 | Other | VA | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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