| NPI | 1710284088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH N TREGASKES Owner 804-282-0510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 04010004312) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: VA 0401004312) |
| Enumeration Date | 2011-02-22 |
| Last Update Date | 2011-04-13 |