# ADAM C PLASTER DDS PC II

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakeside Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457815573
- **Authorized official:** LAURA DOOLEY (OFFICE MANAGER)
- **Authorized official phone:** (540) 912-0177

## Contact information

- **Practice address:** 13245 BOOKER T WASHINGTON HWY STE D, HARDY, VA 24101-3981
- **Practice address phone:** (540) 912-0177
- **Practice address fax:** (540) 912-0179
- **Mailing address:** 13245 BOOKER T WASHINGTON HWY STE D, HARDY, VA 24101-3981
- **Mailing address phone:** (540) 912-0177
- **Mailing address fax:** (540) 912-0179

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/23/2019
- **Last updated:** 01/23/2019