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General NPI Number Information
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NPI Number | 1386976785
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Entity Type | Individual
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Provider Name | PAUL VIRGA D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 02/10/2010
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Last Update Date | 02/10/2010
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Provider Practice Location Address
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Address Line | 24 OXFORD PLACE
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City | MASSAPEQUA
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State | NY
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Zip | 11758-5232
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Country | US
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Telephone | 516-798-7225
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Fax | 516-798-7092
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Provider Business Mailing Address
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Address Line | 24 OXFORD PLACE
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City | MASSAPEQUA
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State | NY
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Zip | 11758-5232
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Country | US
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Telephone | 516-798-7225
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Fax | 516-798-7092
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 032437
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License Number State | NY
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