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General NPI Number Information
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NPI Number | 1730771890
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Entity Type | Organization
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Legal Business Name | CLINE FAMILY DENTISTRY, PLLC
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Dates
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Enumeration Date | 02/09/2021
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Last Update Date | 02/09/2021
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Provider Practice Location Address
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Address Line | 517 TAZEWELL AVE
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City | BLUEFIELD
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State | VA
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Zip | 24605-1724
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Country | US
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Telephone | 276-322-7568
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Fax |
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Provider Business Mailing Address
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Address Line | 517 TAZEWELL AVE
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City | BLUEFIELD
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State | VA
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Zip | 24605-1724
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Country | US
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Telephone | 276-322-7568
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | MISTY M. CLINE
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Credential | DDS
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Telephone | 276-322-7568
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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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