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General NPI Number Information
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NPI Number | 1184862070
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Entity Type | Organization
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Legal Business Name | MAIDSTONE DENTAL
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Dates
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Enumeration Date | 01/30/2009
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Last Update Date | 01/30/2009
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Provider Practice Location Address
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Address Line | 7780 INVICTA LANE
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City | NEW KENT
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State | VA
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Zip | 23124
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Country | US
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Telephone | 804-966-8115
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Fax |
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Provider Business Mailing Address
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Address Line | 10950 CONTINENTAL RD
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City | QUINTON
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State | VA
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Zip | 23141-2153
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Country | US
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Telephone | 804-932-4773
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANA MILENA MAYA ADKINS
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Credential | DMD
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Telephone | 804-335-8113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 410364
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License Number State | VA
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