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General NPI Number Information
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NPI Number | 1790964286
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Entity Type | Organization
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Legal Business Name | DR PHILIP J RENDER DMD
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 7198 CHAPMAN DR
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City | HAYES
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State | VA
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Zip | 23072-3416
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Country | US
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Telephone | 804-684-9971
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Fax | 804-642-2097
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Provider Business Mailing Address
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Address Line | 7198 CHAPMAN DR
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City | HAYES
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State | VA
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Zip | 23072
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Country | US
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Telephone | 804-684-9971
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Fax | 804-642-2097
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. PHILIP JOSEPH RENDER
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Credential | DMD
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Telephone | 804-684-9971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 0401008390
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License Number State | VA
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