| Pine Dentistry | |
|
3533 Plank Rd Suite #a Fredericksburg VA 22407-6830 | |
| (770) 916-5028 | |
| Not Available |
| Full Name | Pine Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3533 Plank Rd, Fredericksburg, Virginia |
| Authorized Official Name and Position | Michelle Jacomino (DIRECTOR OF PAYOR RELATIONS) |
| Authorized Official Contact | 7709165036 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Dentistry 210 Interstate North Pkwy Se Ste 300 Atlanta GA 30339-2233 Ph: (770) 916-9000 | Pine Dentistry 3533 Plank Rd Suite #a Fredericksburg VA 22407-6830 Ph: (770) 916-5028 |
| NPI Number | 1447443080 |
|---|---|
| Provider Enumeration Date | 08/27/2007 |
| Last Update Date | 01/18/2024 |
| Certification Date | 01/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447443080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | (NU) | Secondary |
| 1223G0001X | Dentist - General Practice | (NU) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (NU) | Secondary |
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