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General NPI Number Information
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NPI Number | 1487126207
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Entity Type | Organization
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Legal Business Name | RAQUEL J PAGAN DDS PC
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Dates
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Enumeration Date | 12/18/2018
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Last Update Date | 12/18/2018
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Provider Practice Location Address
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Address Line | 8201 16TH ST STE 123
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City | SILVER SPRING
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State | MD
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Zip | 20910-3255
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Country | US
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Telephone | 571-438-0981
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Fax |
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Provider Business Mailing Address
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Address Line | 4781 OLD DOMINION DR
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City | ARLINGTON
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State | VA
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Zip | 22207-2731
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Country | US
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Telephone | 571-309-1550
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAQUEL J PAGAN
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Credential | DDS
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Telephone | 571-309-1550
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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 |
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License Number State |
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