| Julian W. Fields D.d.s., Ltd. | |
|
2180 Lynch Mill Rd Altavista VA 24517-1150 | |
| (434) 369-4702 | |
| (434) 369-4703 |
| Full Name | Julian W. Fields D.d.s., Ltd. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2180 Lynch Mill Rd, Altavista, Virginia |
| Authorized Official Name and Position | Julian W. Fields (DENTIST/OWNER) |
| Authorized Official Contact | 4343694702 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Julian W. Fields D.d.s., Ltd. 2180 Lynch Mill Rd Altavista VA 24517-1150 Ph: (434) 369-4702 | Julian W. Fields D.d.s., Ltd. 2180 Lynch Mill Rd Altavista VA 24517-1150 Ph: (434) 369-4702 |
| NPI Number | 1861658726 |
|---|---|
| Provider Enumeration Date | 07/31/2008 |
| Last Update Date | 07/31/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861658726 | NPI | - | NPPES |
| 108554 | Other | VA | MEDICAID LOCATION NUMBER |
| 1245383397 | Other | VA | INDIVIDUAL PROVIDER NPI |
| 463565 | Other | VA | BLUE CROSS BLUE SHIELD PROVIDER NUMBER |
| 1578533063 | Other | VA | INDIVIDUAL PROVIDER NPI |
| 9180988 | Medicaid | VA | |
| 342746 | Other | VA | BLUE CROSS BLUE SHIELD PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 0401008664 (Virginia) | Primary |
| 261QD0000X | Clinic/center - Dental | 0401007246 (Virginia) | Secondary |
Brenda M Elliott Dds Plc Dental Clinic Medicare: Medicare Enrolled Practice Location: 1208 Main St, Altavista, VA 24517 Phone: 434-369-6244 | |
Altavista Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2180 Lynch Mill Rd, Altavista, VA 24517 Phone: 434-369-4702 Fax: 434-369-4703 |