Healthcare Provider Details

I. General information

NPI: 1982007852
Provider Name (Legal Business Name): ALLEGHANY HIGHLANDS DENTAL CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2014
Last Update Date: 11/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6084 SAM SNEAD HWY
HOT SPRINGS VA
24445-2664
US

IV. Provider business mailing address

1090 NORTHCHASE PKWY SE STE 150
MARIETTA GA
30067-6405
US

V. Phone/Fax

Practice location:
  • Phone: 540-839-3500
  • Fax:
Mailing address:
  • Phone: 770-916-5031
  • Fax: 678-247-7966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. ADAM PLASTER
Title or Position: PRESIDENT
Credential: DDS
Phone: 540-839-3500