Commonwealth Dental Clinic

NPI 1144641309 - Clinic/Center - 261QD0000X

NPI Details
NPI 1144641309
Enumeration Date 12/13/2013
Last Updated 12/13/2013
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name GREGORY TODD GREGORY
Position PRESIDENT
Phone (540) 685-0028
Fax
Practice Location
1121 S JEFFERSON ST
ROANOKE VA, 24016-4703, US
Phone (540) 685-0028
Fax
Business Location
1618 W MAIN ST
SALEM VA, 24153-3116, US
Phone (540) 685-0028
Fax
Toxanomy
Taxonomy Code 261QD0000X
License State Virginia
License Number 0401410880
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According to our database, Commonwealth Dental Clinic NPI is 1144641309, taxonomy code is 261QD0000X and license number is 0401410880, license state is located at Virginia. Commonwealth Dental Clinic physically located at 1121 S Jefferson St, Roanoke VA, 24016-4703. NPI Number 1033115704 has the healthcare provider type.

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1144641309 NPI number is provided on an as is basis without warranty of any kind. 1144641309 is maintained by the National Plan & Provider Enumeration System. The contents of Commonwealth Dental Clinic are for informational purposes only.