Organization
ROANOKE ORAL SURGERY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES T. MCCLUNG JR. DDS (PRESIDENT)
(540) 362-5900
Entity
Organization
Contact information
Practice address
6027 PETERS CREEK RD, ROANOKE, VA 24019-4029
(540) 362-5900
(540) 366-5131
Mailing address
PO BOX 7889, ROANOKE, VA 24019-0889
(540) 362-5900
(540) 366-5131
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401004673
VA
Other
Enumeration date
11/16/2007
Last updated
11/16/2007
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