Organization · Type 2 NPI

Coliseum Pediatric Dentistry Surgery Center

Ambulatory Surgical Clinic/Center · Hampton, VA

NPI number 1700631801 Active

Practice location

2113 Hartford Rd
Hampton, VA 23666-2575

Call (757) 327-7843 Map

Other practice locations

2111 Hartford Rd, Hampton, VA 23666-2576 · (757) 327-7843

Specialties and licenses

Taxonomy	Code	License
Pediatric Dentistry	1223P0221X	None listed
Ambulatory Surgical Clinic/Center Primary	261QA1903X	None listed

Ambulatory Surgical Clinic/Center: Definition to come...

3 other providers at this address

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Mark J Kanter MD PCAmbulatory Surgical Clinic/Center Hampton, VA NPI 1700967783

See all in Hampton →

NPI record

NPI: 1700631801
Entity type: Organization (Type 2)
Issued: Apr 22, 2024
Last updated: Apr 22, 2024
Status: Active
Subpart: Yes of Coliseum Pediatric Dentistry PLLC

Other names

Coliseum Pediatric Dentistry Surgery Center · doing business as

Authorized official

Chris Cannon
RCM
(757) 327-4843

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1700631801

Coliseum Pediatric Dentistry Surgery Center's National Provider Identifier is 1700631801, issued on Apr 22, 2024. The primary taxonomy on file is Ambulatory Surgical Clinic/Center (261QA1903X), and the practice location is in Hampton, VA. The record was last updated on Apr 22, 2024.