# PHILLIP D PRATER DDD PLLC

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

## Provider details

- **NPI number:** 1891186441
- **Authorized official:** DR. PHILLIP D PRATER DDS (OWNER)
- **Authorized official phone:** (434) 292-3695

## Contact information

- **Practice address:** 929 S MAIN ST, BLACKSTONE, VA 23824-2610
- **Practice address phone:** (434) 292-3695
- **Mailing address:** 929 S MAIN ST, BLACKSTONE, VA 23824-2610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401414364 | VA | Yes |

## Other

- **Enumeration date:** 02/17/2015
- **Last updated:** 02/17/2015