| NPI | 1003321365 |
|---|---|
| Doing Business As | VALLEYGATE DENTAL SURGERY CENTER |
| Entity Type | Organization |
| Authorized Contact | VIRGINIA JONES Chief Executive Officer 910-485-7070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Additional Taxonomies | 1223D0004X Dentist Dentist Anesthesiologist |
| 1223E0200X Dentist Endodontics | |
| 1223P0106X Dentist Oral and Maxillofacial Pathology | |
| 1223P0221X Dentist Pediatric Dentistry | |
| 1223P0300X Dentist Periodontics | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 1223X0008X Dentist Oral and Maxillofacial Radiology | |
| 163WP0200X Registered Nurse Pediatrics | |
| 204E00000X Oral & Maxillofacial Surgery | |
| 207L00000X Anesthesiology | |
| 2086S0127X Surgery Trauma Surgery | |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2019-10-25 |