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General NPI Number Information
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NPI Number | 1487842456
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Entity Type | Organization
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Legal Business Name | JASON R. PAIGE DDS PC
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 10/04/2007
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Provider Practice Location Address
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Address Line | 2928 NORTH AVE
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City | RICHMOND
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State | VA
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Zip | 23222-3613
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Country | US
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Telephone | 804-321-4065
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Fax | 804-321-6493
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Provider Business Mailing Address
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Address Line | 2928 NORTH AVE
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City | RICHMOND
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State | VA
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Zip | 23222-3613
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Country | US
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Telephone |
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Fax | 804-321-6493
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JASON R PAIGE
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Credential | DDS
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Telephone | 804-321-4065
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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 | 0401411595
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License Number State | VA
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