Provider Demographics
NPI:1487196309
Name:ATKINS, MAESTRELLO, MILLER AND ASSOCIATES PEDIATRIC DENTISTRY, PC
Entity Type:Organization
Organization Name:ATKINS, MAESTRELLO, MILLER AND ASSOCIATES PEDIATRIC DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-741-2226
Mailing Address - Street 1:2560 GASKINS RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-1468
Mailing Address - Country:US
Mailing Address - Phone:804-741-2226
Mailing Address - Fax:804-741-6751
Practice Address - Street 1:2560 GASKINS RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-1468
Practice Address - Country:US
Practice Address - Phone:804-741-2226
Practice Address - Fax:804-741-6751
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL VIRGINIA DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty