| Pruden Family Dentistry | |
| 
					2303 Pruden Blvd Suffolk VA 23434-4330  | |
| (757) 539-9481 | |
| Not Available | 
| Full Name | Pruden Family Dentistry | 
|---|---|
| Speciality | Clinic/center - Dental | 
| Location | 2303 Pruden Blvd, Suffolk, Virginia | 
| Authorized Official Name and Position | Donna Renee Johnson (GENERAL MANAGER) | 
| Authorized Official Contact | 7573574121 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Pruden Family Dentistry 2303 Pruden Blvd Suffolk VA 23434-4330 Ph: (757) 539-9481  | Pruden Family Dentistry 2303 Pruden Blvd Suffolk VA 23434-4330 Ph: (757) 539-9481  | 
| NPI Number | 1972261527 | 
|---|---|
| Provider Enumeration Date | 12/01/2021 | 
| Last Update Date | 12/01/2021 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1972261527 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary | 
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