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NPI Code Detail

MEDICARE: MASTROS & WITTY FAMILY DENTISTRY PC

MEDICARE: MASTROS & WITTY FAMILY DENTISTRY PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center0401411471VA

General Provider Information

NPI Number : 1902819303
Entity Type Code : Organization
Provider Name (Legal Business Name) : MASTROS & WITTY FAMILY DENTISTRY PC
Provider Business Mailing Address
First Line : 41 OLD OYSTER POINT RD
Second Line : SUITE H
City : NEWPORT NEWS
State : VA
Zip : 23602-7177
Country : US
Telephone Number : 757-249-5128
Fax Number : 757-249-0875
Provider Business Practice Location Address
First Line : 41 OLD OYSTER POINT RD
Second Line : SUITE H
City : NEWPORT NEWS
State : VA
Zip : 23602-7177
Country : US
Telephone Number : 757-249-5128
Fax Number : 757-249-0875
Authorized Official
Title or Position : PRES.
Name : DR. KRISTIN LEIGH MASTROS
Credential : D.D.S.
Telephone Number : 757-249-5128
Provider Enumeration Date : 08/15/2006
Last Update Date : 12/20/2012

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Directions to “MASTROS & WITTY FAMILY DENTISTRY PC ” Practice Location

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