Mountain Kids, Inc. | |
200 East Riverside Drive North Tazewell VA 24630 | |
(276) 988-5583 | |
(276) 979-1441 |
Full Name | Mountain Kids, Inc. |
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Speciality | Dentist - General Practice |
Location | 200 East Riverside Drive, North Tazewell, Virginia |
Authorized Official Name and Position | Marcus Brandon Buskill (DENTIST) |
Authorized Official Contact | 2769885583 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mountain Kids, Inc. Po Box 1298 200 East Riverside Drive North Tazewell VA 24630-1298 Ph: (276) 988-5583 | Mountain Kids, Inc. 200 East Riverside Drive North Tazewell VA 24630 Ph: (276) 988-5583 |
NPI Number | 1235140716 |
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Provider Enumeration Date | 08/10/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1235140716 | NPI | - | NPPES |
9182558 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 0401411127 (Virginia) | Primary |