Healthcare Provider Details

I. General information

NPI: 1891821906
Provider Name (Legal Business Name): DRS. PIKE & VALEGA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19601 FISHER AVE
POOLESVILLE MD
20837-2071
US

IV. Provider business mailing address

PO BOX 898
POOLESVILLE MD
20837-0898
US

V. Phone/Fax

Practice location:
  • Phone: 301-972-7000
  • Fax: 301-349-2780
Mailing address:
  • Phone: 301-972-7000
  • Fax: 301-349-2780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number9768
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number9702
License Number StateMD

VIII. Authorized Official

Name: DR. MARGARET VALEGA
Title or Position: OWNER
Credential: DDS
Phone: 301-972-7000