| Va Southern Dental Ppo Pc | |
|
1315 Emancipation Hwy Fredericksburg VA 22401-4640 | |
| (540) 899-1777 | |
| Not Available |
| Full Name | Va Southern Dental Ppo Pc |
|---|---|
| Speciality | Dentist |
| Location | 1315 Emancipation Hwy, Fredericksburg, Virginia |
| Authorized Official Name and Position | Erika Melissa Menjivar (SR. CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 4695966137 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Va Southern Dental Ppo Pc 5830 Granite Pkwy Ste 780 Plano TX 75024-6775 Ph: () - | Va Southern Dental Ppo Pc 1315 Emancipation Hwy Fredericksburg VA 22401-4640 Ph: (540) 899-1777 |
| NPI Number | 1053293746 |
|---|---|
| Provider Enumeration Date | 07/23/2025 |
| Last Update Date | 07/23/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053293746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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