| Roanoke Pediatric Dre Llc | |
| 
					6112 Peters Creek Rd Hollins VA 24019-4028  | |
| (859) 785-8312 | |
| Not Available | 
| Full Name | Roanoke Pediatric Dre Llc | 
|---|---|
| Speciality | Dentist - Pediatric Dentistry | 
| Location | 6112 Peters Creek Rd, Hollins, Virginia | 
| Authorized Official Name and Position | James Gregory White (CEO) | 
| Authorized Official Contact | 8597858312 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Roanoke Pediatric Dre Llc 105 Spruce St Lexington KY 40507-2109 Ph: () -  | Roanoke Pediatric Dre Llc 6112 Peters Creek Rd Hollins VA 24019-4028 Ph: (859) 785-8312  | 
| NPI Number | 1659076685 | 
|---|---|
| Provider Enumeration Date | 03/31/2023 | 
| Last Update Date | 03/31/2023 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1659076685 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |