| Michael Edenfield, Dds Pc | |
|
6263 Portsmouth Blvd Portsmouth VA 23701-1344 | |
| (757) 488-1285 | |
| (757) 465-9132 |
| Full Name | Michael Edenfield, Dds Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6263 Portsmouth Blvd, Portsmouth, Virginia |
| Authorized Official Name and Position | Nicola J Pismeny (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 7574881285 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Edenfield, Dds Pc 6263 Portsmouth Blvd Portsmouth VA 23701-1344 Ph: (757) 488-1285 | Michael Edenfield, Dds Pc 6263 Portsmouth Blvd Portsmouth VA 23701-1344 Ph: (757) 488-1285 |
| NPI Number | 1194013474 |
|---|---|
| Provider Enumeration Date | 07/20/2011 |
| Last Update Date | 07/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194013474 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 0401008978 (Virginia) | Primary |
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