Healthcare Provider Details

I. General information

NPI: 1245293737
Provider Name (Legal Business Name): MICHAEL FRANK MAUGERI JR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 HOLLAND RD SUITE 100
VIRGINIA BEACH VA
23452-2859
US

IV. Provider business mailing address

3720 HOLLAND RD SUITE 100
VIRGINIA BEACH VA
23452-2859
US

V. Phone/Fax

Practice location:
  • Phone: 757-340-0446
  • Fax: 757-340-8504
Mailing address:
  • Phone: 757-340-0446
  • Fax: 757-340-8504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: