VA SOUTHERN DENTAL PPO PC

FREDERICKSBURG, VA
NPI1053293746
Doing Business AsBIG SMILE DENTAL
Entity TypeOrganization
Authorized ContactERIKA MELISSA MENJIVAR
Sr. Credentialing Specialist
469-596-6137
Organization Subpart ?Yes
Primary Taxonomy122300000X Dentist
Enumeration Date2025-07-23
Last Update Date2025-07-23
Business Address
VA SOUTHERN DENTAL PPO PC
1315 EMANCIPATION HWY
FREDERICKSBURG, VA 22401-4640
Phone number: 540-899-1777
Mailing Address
VA SOUTHERN DENTAL PPO PC
5830 GRANITE PKWY STE 780
PLANO, TX 75024-6775
Phone number: