Provider Demographics
NPI:1215560370
Name:RED APPLE PEDIATRIC DENTAL TEAM
Entity type:Organization
Organization Name:RED APPLE PEDIATRIC DENTAL TEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT DESK
Authorized Official - Prefix:
Authorized Official - First Name:SKYLAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-318-5577
Mailing Address - Street 1:1003 GARRISONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-1843
Mailing Address - Country:US
Mailing Address - Phone:540-318-5577
Mailing Address - Fax:540-369-6250
Practice Address - Street 1:1003 GARRISONVILLE RD
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-1843
Practice Address - Country:US
Practice Address - Phone:540-318-5577
Practice Address - Fax:540-369-6250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty