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General NPI Number Information
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NPI Number | 1912542713
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Entity Type | Organization
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Legal Business Name | MICHAEL A DENTE JR DPM PLC
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Dates
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Enumeration Date | 11/15/2019
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Last Update Date | 12/13/2019
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Provider Practice Location Address
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Address Line | 356 MCLAWS CIR STE 1
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-6345
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Country | US
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Telephone | 757-358-3183
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Fax |
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Provider Business Mailing Address
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Address Line | 356 MCLAWS CIR STE 1
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-6345
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Country | US
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Telephone | 757-358-3183
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MICHAEL A DENTE JR.
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Credential | DPM
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Telephone | 757-358-3183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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