Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Public Health or Welfare |
251K00000X | 60 | Public Health or Welfare Agency |
| NPI # | 1871680082 |
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| LBN Legal business name | ROANOKE CO/SALEM DENTAL CLINIC | ||||
| Authorized official | SUSAN HOEL - (BUSINESS MANAGER A) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 10/07/2006 | ||||
| Last updated | 08/22/2020 - About 6 years ago | ||||
| Identifiers |
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