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General NPI Number Information
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NPI Number | 1386736247
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Entity Type | Organization
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Legal Business Name | ATKINS, MAESTRELLO & ASSOCIATES PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 2560 GASKINS RD
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City | RICHMOND
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State | VA
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Zip | 23238-1468
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Country | US
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Telephone | 804-741-2226
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Fax | 804-741-6751
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Provider Business Mailing Address
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Address Line | 2560 GASKINS RD
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City | RICHMOND
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State | VA
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Zip | 23238-1468
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Country | US
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Telephone | 804-741-2226
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Fax | 804-741-6751
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. GAIL GAINES KENDRICK
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Credential |
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Telephone | 804-741-2226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 0401006142
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License Number State | VA
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