Provider Demographics
NPI:1497424485
Name:CHESTER ORAL SURGERY, PC
Entity Type:Organization
Organization Name:CHESTER ORAL SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORA SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:W
Authorized Official - Last Name:BRINSER
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-748-6350
Mailing Address - Street 1:11971 IRON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-1458
Mailing Address - Country:US
Mailing Address - Phone:804-748-6350
Mailing Address - Fax:804-796-1415
Practice Address - Street 1:11971 IRON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1458
Practice Address - Country:US
Practice Address - Phone:804-748-6350
Practice Address - Fax:804-796-1415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty