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General NPI Number Information
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NPI Number | 1689910044
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Entity Type | Organization
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Legal Business Name | PEDRO L CASINGAL JR DDS PC
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Dates
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Enumeration Date | 12/12/2012
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Last Update Date | 12/12/2012
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Provider Practice Location Address
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Address Line | 810 BATTLEFIELD BLVD S
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City | CHESAPEAKE
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State | VA
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Zip | 23322-6611
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Country | US
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Telephone | 757-482-7977
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Fax | 757-482-8769
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Provider Business Mailing Address
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Address Line | 810 BATTLEFIELD BLVD S
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City | CHESAPEAKE
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State | VA
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Zip | 23322-6611
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Country | US
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Telephone | 757-482-7977
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Fax | 757-482-8769
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Authorized Official
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Title or Position | DENTIST
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Name | DR. PEDRO L CASINGAL JR.
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Credential | DDS
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Telephone | 757-482-7977
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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 | 0401008632
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License Number State | VA
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