| Lee Family Dental Plc | |
|
153 E Morgan Ave Pennington Gap VA 24277-2643 | |
| (276) 546-2042 | |
| (276) 546-3029 |
| Full Name | Lee Family Dental Plc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 153 E Morgan Ave, Pennington Gap, Virginia |
| Authorized Official Name and Position | Stephen Ross Shelburne (OWNER) |
| Authorized Official Contact | 2765462042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lee Family Dental Plc 153 E Morgan Ave Pennington Gap VA 24277-2643 Ph: (276) 546-2042 | Lee Family Dental Plc 153 E Morgan Ave Pennington Gap VA 24277-2643 Ph: (276) 546-2042 |
| NPI Number | 1730336173 |
|---|---|
| Provider Enumeration Date | 08/27/2008 |
| Last Update Date | 10/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730336173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401412170 (Virginia) | Primary |
Roy S. Shelburne, Dds, Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 153 E Morgan Ave, Pennington Gap, VA 24277 Phone: 276-546-2042 Fax: 276-546-3029 |