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Contact Information

SOUTHSIDE ENDODONTICS, PC
2425 BOULEVARD
SUITE 8
COLONIAL HEIGHTS, VA23834-2324
 Phone: 804-520-0000
 Fax: 804-520-2111
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for SOUTHSIDE ENDODONTICS PC · (Female)

NPI # 1053494260
Status Active
Credentials
Entity Individual
Enumeration date 10/23/2006
Last updated 03/06/2009 - About 17 years ago
Sole proprietor 1 Not specified
Identifiers
  • VA License # 401007706
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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