Provider Demographics
NPI:1841326527
Name:TRAHOS, MICHAEL N (DDS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:N
Last Name:TRAHOS
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 1:18204 SPARTA RD
Mailing Address - Street 2:POB 520
Mailing Address - City:MILFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22514-2208
Mailing Address - Country:US
Mailing Address - Phone:804-633-2171
Mailing Address - Fax:
Practice Address - Street 1:18204 SPARTA RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:VA
Practice Address - Zip Code:22514-2208
Practice Address - Country:US
Practice Address - Phone:804-633-2171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010039051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice