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General NPI Number Information
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NPI Number | 1275216541
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Entity Type | Organization
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Legal Business Name | AFFORDABLE DENTURES & IMPLANTS - CHRISTIANSBURG, P.C.
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Dates
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Enumeration Date | 08/11/2023
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 175 CONSTON AVE
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City | CHRISTIANSBURG
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State | VA
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Zip | 24073-1151
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Country | US
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Telephone | 540-288-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 175 CONSTON AVE
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City | CHRISTIANSBURG
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State | VA
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Zip | 24073-1151
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Country | US
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Telephone | 540-288-4200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY BRIAN PETTIT
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Credential | DDS
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Telephone | 540-288-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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