Individual
DR. AGUSTIN SEBASTIAN PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
710 DENBIGH BLVD, STE 5A, NEWPORT NEWS, VA 23608-4427
(757) 877-6003
(757) 833-7063
Mailing address
710 DENBIGH BLVD, STE 5A, NEWPORT NEWS, VA 23608-4427
(757) 877-6003
(757) 833-7063
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401007584
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054957
BCBS
VA
01
—
587049
UNITED CONCORDIA
VA
05
—
9182624
—
VA
Enumeration date
11/09/2006
Last updated
07/09/2007
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