Provider Demographics
NPI:1538204185
Name:ROGER E WOOD NICHOLAS C LOMBARDOZZI DDS PC
Entity type:Organization
Organization Name:ROGER E WOOD NICHOLAS C LOMBARDOZZI DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:LOMBARDOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-794-3498
Mailing Address - Street 1:11601 ROBIOUS ROAD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113
Mailing Address - Country:US
Mailing Address - Phone:804-794-3498
Mailing Address - Fax:804-794-8344
Practice Address - Street 1:11601 ROBIOUS ROAD
Practice Address - Street 2:SUITE 130
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113
Practice Address - Country:US
Practice Address - Phone:804-794-3498
Practice Address - Fax:804-794-8344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty