# DENTAL PROFESSIONALS OF VIRGINIA, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DENTAL PROFESSIONALS OF VIRGINIA, P.C.
- **Other names:** Tinker Creek Dental Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790528784
- **Legal business name:** DENTAL PROFESSIONALS OF VIRGINIA, P.C.
- **Authorized official:** CEMYIRA MCDOUGAL (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 764-8609

## Contact information

- **Practice address:** 3911 CHALLENGER AVE, ROANOKE, VA 24012-6733
- **Practice address phone:** (540) 581-8095
- **Practice address fax:** (540) 581-8096
- **Mailing address:** 3911 CHALLENGER AVE, ROANOKE, VA 24012-6733
- **Mailing address phone:** (540) 581-8095
- **Mailing address fax:** (540) 581-8096

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/17/2024
- **Last updated:** 06/17/2024