| Sea Dental Group Pllc | |
|
11934 W Broad St Ste 120 Henrico VA 23233-1100 | |
| (818) 800-2221 | |
| Not Available |
| Full Name | Sea Dental Group Pllc |
|---|---|
| Speciality | Dentist - Dentist Anesthesiologist |
| Location | 11934 W Broad St Ste 120, Henrico, Virginia |
| Authorized Official Name and Position | Salar Ebrahimi (PRESIDENT) |
| Authorized Official Contact | 8188002221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sea Dental Group Pllc 17113 Bold Venture Dr Leesburg VA 20176-7169 Ph: (818) 800-2221 | Sea Dental Group Pllc 11934 W Broad St Ste 120 Henrico VA 23233-1100 Ph: (818) 800-2221 |
| NPI Number | 1578283982 |
|---|---|
| Provider Enumeration Date | 08/29/2022 |
| Last Update Date | 08/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578283982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0004X | Dentist - Dentist Anesthesiologist | (* (Not Available)) | Primary |
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