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General NPI Number Information
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NPI Number | 1003900234
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Entity Type | Organization
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Legal Business Name | MICHAEL P. MCCORMICK JR., D.D.S., P.C.
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 12/12/2014
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Provider Practice Location Address
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Address Line | 901 ENTERPRISE PKWY STE 500 SUITE 500
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City | HAMPTON
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State | VA
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Zip | 23666-6253
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Country | US
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Telephone | 757-896-4900
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Fax | 757-896-4905
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Provider Business Mailing Address
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Address Line | 901 ENTERPRISE PKWY STE 500 SUITE 500
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City | HAMPTON
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State | VA
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Zip | 23666-6253
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Country | US
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Telephone | 757-896-4900
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Fax | 757-896-4905
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MICHELLE G. BUNCH
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Credential |
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Telephone | 757-896-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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