Provider Demographics
NPI:1811448079
Name:DRS. ROSSETTI, MYERS, & KONDROSSY, DDS
Entity type:Organization
Organization Name:DRS. ROSSETTI, MYERS, & KONDROSSY, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:C
Authorized Official - Last Name:KONDOROSSY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-747-0090
Mailing Address - Street 1:2613 N PARHAM RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294
Mailing Address - Country:US
Mailing Address - Phone:804-747-0090
Mailing Address - Fax:804-270-9461
Practice Address - Street 1:2613 N PARHAM RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294
Practice Address - Country:US
Practice Address - Phone:804-747-0090
Practice Address - Fax:804-270-9461
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL VIRGINIA DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-21
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty