Roanoke Pediatric Dentistry, Llc | |
6112 Peters Creek Rd Roanoke VA 24019-4028 | |
(540) 563-1660 | |
Not Available |
Full Name | Roanoke Pediatric Dentistry, Llc |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 6112 Peters Creek Rd, Roanoke, Virginia |
Authorized Official Name and Position | Corey Joe Sheppard (OWNER) |
Authorized Official Contact | 5405631660 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Roanoke Pediatric Dentistry, Llc 6112 Peters Creek Rd Roanoke VA 24019-4028 Ph: (540) 563-1660 | Roanoke Pediatric Dentistry, Llc 6112 Peters Creek Rd Roanoke VA 24019-4028 Ph: (540) 563-1660 |
NPI Number | 1255841433 |
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Provider Enumeration Date | 10/02/2017 |
Last Update Date | 10/02/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255841433 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 0401413481 (Virginia) | Primary |
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