Organization
MACGREGOR ENTERPRISES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA L TILLAGE (OFFICE MANAGER)
(757) 594-9005
Entity
Organization
Contact information
Practice address
703 THIMBLE SHOALS BLVD, SUITE C-3, NEWPORT NEWS, VA 23606-2576
(757) 594-9005
(757) 594-9215
Mailing address
703 THIMBLE SHOALS BLVD, SUITE C-3, NEWPORT NEWS, VA 23606-2576
(757) 594-9005
(757) 594-9215
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401005891
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245250927
—
VA
Enumeration date
04/25/2008
Last updated
04/25/2008
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