Healthcare Provider Details

I. General information

NPI: 1710284088
Provider Name (Legal Business Name): JOSEPH N TREGASKES DMD MS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2011
Last Update Date: 04/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008 BREMO RD SUITE 104
RICHMOND VA
23226-2443
US

IV. Provider business mailing address

2008 BREMO RD SUITE 104
RICHMOND VA
23226-2443
US

V. Phone/Fax

Practice location:
  • Phone: 804-282-0510
  • Fax: 804-282-1346
Mailing address:
  • Phone: 804-282-0510
  • Fax: 804-282-1346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number0401004312
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number04010004312
License Number StateVA

VIII. Authorized Official

Name: DR. JOSEPH N TREGASKES
Title or Position: OWNER
Credential: DMD MS
Phone: 804-282-0510