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General NPI Number Information
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NPI Number | 1003131731
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Entity Type | Organization
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Legal Business Name | PHILIP J. PANDOLFI, DMD, PLLC
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Dates
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Enumeration Date | 04/06/2010
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Last Update Date | 04/06/2010
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Provider Practice Location Address
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Address Line | 2105 EVELYN BYRD AVE
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City | HARRISONBURG
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State | VA
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Zip | 22801-5431
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Country | US
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Telephone | 540-433-1751
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Fax | 540-433-1756
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Provider Business Mailing Address
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Address Line | 2105 EVELYN BYRD AVE
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City | HARRISONBURG
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State | VA
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Zip | 22801-5431
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Country | US
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Telephone | 540-433-1751
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Fax | 540-433-1756
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. PHILIP J. PANDOLFI
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Credential |
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Telephone | 15404331751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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