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3020 Shore Dr Suite A Virginia Beach VA 23451-1295 | |
| (757) 481-3893 | |
| (757) 481-0425 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3020 Shore Dr, Virginia Beach, Virginia |
| Authorized Official Name and Position | Dagoberto Gonzalos Zapatero (SOLE PROPRIETOR) |
| Authorized Official Contact | 7574813893 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3020 Shore Dr Suite A Virginia Beach VA 23451-1295 Ph: (757) 481-3893 | 3020 Shore Dr Suite A Virginia Beach VA 23451-1295 Ph: (757) 481-3893 |
| NPI Number | 1740472729 |
|---|---|
| Provider Enumeration Date | 08/14/2007 |
| Last Update Date | 08/14/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740472729 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401007450 (Virginia) | Primary |
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