MEDICARE: SCHONBRUN DENTAL CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	401007611	VA

General Provider Information

NPI Number	:	1245660885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHONBRUN DENTAL CARE

Provider Business Mailing Address
First Line	:	4529 E HONEYGROVE RD
Second Line	:	SUITE 301
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-6087
Country	:	US
Telephone Number	:	757-460-1234
Fax Number	:	757-464-2524

Provider Business Practice Location Address
First Line	:	4529 E HONEYGROVE RD
Second Line	:	SUITE 301
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-6087
Country	:	US
Telephone Number	:	757-460-1234
Fax Number	:	757-464-2524

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. DAVID W SCHONBRUN
Credential	:	DDS
Telephone Number	:	757-460-1234

Provider Enumeration Date	:	11/18/2013
Last Update Date	:	11/18/2013

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Directions to “SCHONBRUN DENTAL CARE ” Practice Location

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