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General NPI Number Information
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NPI Number | 1265192751
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Entity Type | Organization
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Legal Business Name | VINCAS V. SIDRYS, D.M.D., PLLC
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Dates
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Enumeration Date | 12/23/2021
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 5000 BRAMBLETON AVE
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City | ROANOKE
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State | VA
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Zip | 24018-4642
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Country | US
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Telephone | 540-769-6370
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Fax | 540-769-6373
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Provider Business Mailing Address
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Address Line | 5000 BRAMBLETON AVE
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City | ROANOKE
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State | VA
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Zip | 24018-4642
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Country | US
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Telephone | 540-769-6370
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Fax | 540-769-6373
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Authorized Official
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Title or Position | MEMBER
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Name | VINCAS SIDRYS
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Credential | DMD
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Telephone | 312-231-5158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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