Organization
RUSSELL COUNTY DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REISA SLOCE (COO)
(276) 889-7621
Entity
Organization
Contact information
Practice address
133 HIGHLAND DR STE A, LEBANON, VA 24266-7209
(276) 889-7621
(276) 889-7695
Mailing address
PO BOX 2347, LEBANON, VA 24266-2347
(276) 889-7621
(276) 889-7695
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/31/2006
Last updated
09/14/2022
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