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General NPI Number Information
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NPI Number | 1508079468
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Entity Type | Organization
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Legal Business Name | MARTIN J MENGES JR DDS
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12528 WARWICK BLVD
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-2676
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Country | US
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Telephone | 757-591-8515
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Fax | 757-591-8517
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Provider Business Mailing Address
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Address Line | 12528 WARWICK BLVD
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-2676
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Country | US
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Telephone | 757-591-8515
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Fax | 757-591-8517
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARTIN M MENGES JR.
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Credential | DDS
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Telephone | 757-591-8515
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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 | 005135
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License Number State | VA
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