# GLADE DENTAL CLINIC

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

## Provider details

- **NPI number:** 1841692522
- **Authorized official:** NICKIE ASHER (OFFICE MANAGER)
- **Authorized official phone:** (276) 628-9507

## Contact information

- **Practice address:** 634 S MONTE VISTA DR, GLADE SPRING, VA 24340-2712
- **Practice address phone:** (276) 429-5111
- **Practice address fax:** (276) 429-2888
- **Mailing address:** PO BOX 638, GLADE SPRING, VA 24340-0638
- **Mailing address phone:** (276) 429-5111
- **Mailing address fax:** (276) 429-2888

## Taxonomy

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

## Other

- **Enumeration date:** 09/24/2014
- **Last updated:** 09/24/2014