OrganizationColiseum Pediatric Dentistry Surgery CenterClinic/CenterAmbulatory Health Care FacilitiesPractice Address2113 Hartford Rd, Hampton, VA 23666-2575(757) 327-7843(757) 838-0800PECOS EnrollmentBased on the most recent information from CMS, provider Coliseum Pediatric Dentistry Surgery Center does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:51 AM.Profile DetailsProvider ID1700631801Provider TypeOrganizationFull NameColiseum Pediatric Dentistry Surgery CenterSubpartYesEnumeration Date4/22/2024Last Updated4/22/2024Contact InformationPractice LocationPractice Address2113 Hartford Rd, Hampton, VA 23666-2575Phone(757) 327-7843FaxUnlisted FaxMailing LocationMailing Address2113 Hartford Rd, Hampton, VA 23666-2575Phone(757) 838-0800FaxUnlisted FaxAuthorized OfficialNameCannon, Chris (Rcm)Phone(757) 327-4843Provider TaxonomiesCodeDescriptionLicenseCode261QA1903XPrimaryDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseUnlisted IssuerCode1223P0221XDescriptionDentistDental ProvidersLicenseUnlisted Issuer