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General NPI Number Information
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NPI Number | 1346054467
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Entity Type | Organization
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Legal Business Name | CHILDRENS SURGICAL SPECIALTY GROUP INC
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 301 RIVERVIEW AVE STE 300
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City | NORFOLK
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State | VA
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Zip | 23510-1066
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Country | US
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Telephone | 757-668-7713
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Fax | 757-668-7711
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Provider Business Mailing Address
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Address Line | 601 CHILDRENS LN
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City | NORFOLK
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State | VA
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Zip | 23507-1910
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Country | US
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Telephone | 757-668-7017
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Fax |
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Authorized Official
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Title or Position | SENIOR VP/CFO
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Name | KATHRYN J ABSHIRE
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Credential |
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Telephone | 757-668-8565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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