| Lake Plaza Moore-ams, Pllc | |
|
36101 Goodwin Dr Locust Grove VA 22508-2029 | |
| (540) 972-8100 | |
| (540) 972-8300 |
| Full Name | Lake Plaza Moore-ams, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 36101 Goodwin Dr, Locust Grove, Virginia |
| Authorized Official Name and Position | Marhilda Morales (CEO) |
| Authorized Official Contact | 5406800923 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Plaza Moore-ams, Pllc 36101 Goodwin Dr Locust Grove VA 22508-2029 Ph: (540) 972-8100 | Lake Plaza Moore-ams, Pllc 36101 Goodwin Dr Locust Grove VA 22508-2029 Ph: (540) 972-8100 |
| NPI Number | 1710788591 |
|---|---|
| Provider Enumeration Date | 03/19/2025 |
| Last Update Date | 03/19/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710788591 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Lake Plaza Dental Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 36101 Goodwin Dr, Locust Grove, VA 22508 Phone: 540-226-6744 |