Provider Demographics
NPI:1356405740
Name:CHESTERFIELD ORAL SURGERY INC.
Entity type:Organization
Organization Name:CHESTERFIELD ORAL SURGERY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-768-9000
Mailing Address - Street 1:10110 IRON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-6529
Mailing Address - Country:US
Mailing Address - Phone:804-768-9000
Mailing Address - Fax:804-768-9966
Practice Address - Street 1:10110 IRON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6529
Practice Address - Country:US
Practice Address - Phone:804-768-9000
Practice Address - Fax:804-768-9966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty