Phillip D Prater Ddd Pllc | |
929 S Main St Blackstone VA 23824-2610 | |
(434) 292-3695 | |
Not Available |
Full Name | Phillip D Prater Ddd Pllc |
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Speciality | Dentist |
Location | 929 S Main St, Blackstone, Virginia |
Authorized Official Name and Position | Phillip D Prater (OWNER) |
Authorized Official Contact | 4342923695 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Phillip D Prater Ddd Pllc 929 S Main St Blackstone VA 23824-2610 Ph: () - | Phillip D Prater Ddd Pllc 929 S Main St Blackstone VA 23824-2610 Ph: (434) 292-3695 |
NPI Number | 1891186441 |
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Provider Enumeration Date | 02/17/2015 |
Last Update Date | 02/17/2015 |
Identifier | Type | State | Issuer |
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1891186441 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 0401414364 (Virginia) | Primary |