Robert Hall Bodendorf, D.M.D.

Individual provider Active NPI General Practice Dentistry · Orange, VA

NPI 1154479228 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1154479228
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
6638 (VA)
Practice address
111 Spicers Mill Rd # a
Orange, VA 22960-1023
Phone
(540) 672-3661
Fax
(540) 672-1665
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6638VAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6638 VA Yes

Addresses

Primary practice location

111 Spicers Mill Rd # a
Orange, VA 22960-1023

Mailing address

111 Spicers Mill Rd # a
Orange, VA 22960-1023
Phone (540) 672-3661

Other providers in Orange, VA

All providers in Orange, VA · General Practice Dentistry in Virginia

Sources for this page

Verify at the official NPI Registry.