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Funpedopark Llc
Pediatric Dentist in Suffolk, Virginia
NPI 1043842214

Funpedopark Llc is a Pediatric Dentist based in Suffolk, VA and is specialized in Pediatric Dentistry. Funpedopark Llc practices in Suffolk, VA. The NPI Number for Funpedopark Llc is 1043842214 and holds a License No. (Virginia).

The current practice location address for Funpedopark Llc is 1009 Centerbrooke Ln Ste 210, Suffolk, VA and can be reached out via phone at 757-767-7275. You can also correspond with Funpedopark Llc through the mailing address at 1009 CENTERBROOKE LN STE 210, SUFFOLK, VA - 23434-8664 (mailing address contact number: 757-767-7275).

Location: 1009 Centerbrooke Ln Ste 210, Suffolk, VA, 23434-8664
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1043842214
Provider Name
Funpedopark Llc
Credential
Provider Entity Type
Organization
Address
1009 Centerbrooke Ln Ste 210, Suffolk, VA, 23434-8664
Phone Number
757-767-7275
Fax Number
Provider Enumeration Date
02/06/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0401416127 01 VA DENTAL LICENSE
institution
Provider Business Practice Location Address Details
Address
1009 Centerbrooke Ln Ste 210
City
Suffolk
State
Virginia
Zip
23434-8664
Phone Number
757-767-7275
Fax Number
person
Provider Business Mailing Address Details
Address
1009 Centerbrooke Ln Ste 210
City
Suffolk
State
Virginia
Zip
23434-8664
Phone Number
757-767-7275
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
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Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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