Provider Demographics
NPI:1629368170
Name:VEGA, OSCAR G (DDS)
Entity Type:Individual
Prefix:MR
First Name:OSCAR
Middle Name:G
Last Name:VEGA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 304
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:VA
Mailing Address - Zip Code:22727-0304
Mailing Address - Country:US
Mailing Address - Phone:540-948-4488
Mailing Address - Fax:540-948-4662
Practice Address - Street 1:306 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:VA
Practice Address - Zip Code:22727-3026
Practice Address - Country:US
Practice Address - Phone:540-948-4488
Practice Address - Fax:540-948-4662
Is Sole Proprietor?:No
Enumeration Date:2011-04-17
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014136591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice