# CLQ&P DENTISTRY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740995471
- **Authorized official:** MIKE COLE (VP INSURANCE PLAN MANAGEMENT)
- **Authorized official phone:** (727) 424-2990

## Contact information

- **Practice address:** 1930 ELECTRIC RD, ROANOKE, VA 24018-1621
- **Practice address phone:** (540) 989-1170
- **Mailing address:** 1930 ELECTRIC RD, ROANOKE, VA 24018-1621

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 01/17/2023
- **Last updated:** 01/17/2023