MEDICARE: ALLEGHANY HIGHLANDS DENTAL CARE, PC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)
2	1223E0200X	Endodontics
3	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1982007852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEGHANY HIGHLANDS DENTAL CARE, PC

Provider Business Mailing Address
First Line	:	1090 NORTHCHASE PKWY SE
Second Line	:	STE 150
City	:	MARIETTA
State	:	GA
Zip	:	30067-6405
Country	:	US
Telephone Number	:	770-916-5031
Fax Number	:	678-247-7966

Provider Business Practice Location Address
First Line	:	6084 SAM SNEAD HWY
Second Line	:
City	:	HOT SPRINGS
State	:	VA
Zip	:	24445-2664
Country	:	US
Telephone Number	:	540-839-3500
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ADAM PLASTER
Credential	:	DDS
Telephone Number	:	540-839-3500

Provider Enumeration Date	:	10/06/2014
Last Update Date	:	11/02/2015

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