# SOUTHWEST VIRGINIA ORAL & MAXILLOFACIAL SURGERY, PLLC

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

## Provider details

- **NPI number:** 1972996197
- **Authorized official:** DR. SAMUEL E SCROGGINS DMD (LLC MEMBER)
- **Authorized official phone:** (540) 989-5257

## Contact information

- **Practice address:** 3580 KEAGY RD SW, ROANOKE, VA 24018-1152
- **Practice address phone:** (540) 989-5257
- **Practice address fax:** (540) 989-5259
- **Mailing address:** 3580 KEAGY RD SW, ROANOKE, VA 24018-1152
- **Mailing address phone:** (540) 989-5257
- **Mailing address fax:** (540) 989-5259

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 0401413811 | VA | Yes |

## Other

- **Enumeration date:** 03/12/2015
- **Last updated:** 10/24/2024