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General NPI Number Information
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NPI Number | 1124210372
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Entity Type | Individual
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Provider Name | PAMELA F. REGIMBAL D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 08/13/2007
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Provider Practice Location Address
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Address Line | 8266 JUPITER DR
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-2812
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Country | US
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Telephone | 804-746-7720
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Fax | 804-746-8035
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Provider Business Mailing Address
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Address Line | 8266 JUPITER DRIVE
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-2811
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Country | US
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Telephone | 804-746-7720
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Fax | 804-746-8035
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0401007077
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License Number State | VA
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