MEDICARE: ROANOKE ORAL SURGERY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	0401004673	VA

General Provider Information

NPI Number	:	1104007384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROANOKE ORAL SURGERY, INC.

Provider Business Mailing Address
First Line	:	PO BOX 7889
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24019-0889
Country	:	US
Telephone Number	:	540-362-5900
Fax Number	:	540-366-5131

Provider Business Practice Location Address
First Line	:	6027 PETERS CREEK RD
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24019-4029
Country	:	US
Telephone Number	:	540-362-5900
Fax Number	:	540-366-5131

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES T. MCCLUNG JR.
Credential	:	DDS
Telephone Number	:	540-362-5900

Provider Enumeration Date	:	11/16/2007
Last Update Date	:	11/16/2007

Similar Medicare Providers

1962472878 — DR. JAMES T MCCLUNG JR. DDS
Practice Location Address:

6035 PETERS CREEK RD
ROANOKE, VA
24019-4029

Practice Phone: 540-362-5900
Practice Fax: 540-366-5131

1346208337 — GENTLE SHEPHERD HOSPICE INC.
Practice Location Address:

6045 PETERS CREEK RD
ROANOKE, VA
24019-4029

Practice Phone: 540-989-6265
Practice Fax: 540-989-1547

1699016956 — DR. SEAN LEON ESCHENBACH DDS
Practice Location Address:

6027 PETERS CREEK RD
ROANOKE, VA
24019-4029

Practice Phone: 540-366-5373
Practice Fax:

1346788056 — MRS. KIM ECKENROTH NP-C
Practice Location Address:

6045 PETERS CREEK RD
ROANOKE, VA
24019-4029

Practice Phone: 540-989-6265
Practice Fax: 540-989-1547

1457058356 — MRS. KRISTY PETERS RDH
Practice Location Address:

6027 PETERS CREEK RD
ROANOKE, VA
24019-4029

Practice Phone: 540-366-5373
Practice Fax:

1255103198 — SEAN ESCHENBACH, DDS, PLLC
Practice Location Address:

6027 PETERS CREEK RD
ROANOKE, VA
24019-4029

Practice Phone: 540-366-5373
Practice Fax:

Directions to “ROANOKE ORAL SURGERY, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.