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General NPI Number Information
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NPI Number | 1033422886
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Entity Type | Organization
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Legal Business Name | MITCHELL J MAGID ,DMD , PC
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Dates
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Enumeration Date | 07/22/2010
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Last Update Date | 07/22/2010
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Provider Practice Location Address
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Address Line | 1612 GRAVES MILL RD
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City | LYNCHBURG
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State | VA
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Zip | 24502-4329
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Country | US
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Telephone | 434-316-7111
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Fax | 434-316-7114
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Provider Business Mailing Address
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Address Line | 1612 GRAVES MILL RD
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City | LYNCHBURG
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State | VA
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Zip | 24502-4329
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Country | US
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Telephone | 434-316-7111
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Fax | 434-316-7114
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Authorized Official
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Title or Position | OWNER
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Name | DR. MITCHELL J MAGID
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Credential | DMD
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Telephone | 434-316-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 0401412702
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0101247757
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License Number State | VA
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