Provider Demographics
NPI:1013182062
Name:R & C DENTAL, INC.
Entity Type:Organization
Organization Name:R & C DENTAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:BONESTEEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-684-9905
Mailing Address - Street 1:PO BOX 330
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:VA
Mailing Address - Zip Code:23183-0330
Mailing Address - Country:US
Mailing Address - Phone:804-684-9905
Mailing Address - Fax:804-684-3669
Practice Address - Street 1:4121 GEORGE WASHINGTON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:HAYES
Practice Address - State:VA
Practice Address - Zip Code:23072-2931
Practice Address - Country:US
Practice Address - Phone:804-684-9905
Practice Address - Fax:804-684-3669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VABB38389691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7801530Medicaid