Organization
BASS & KAMP SOUTH MAIN LLC
Active
Other names
New River Dental Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN NEIL TEBBENKAMP DDS (MEMBER)
(540) 838-5050
Entity
Organization
Contact information
Practice address
210 PROFESSIONAL PARK DR SE STE 11, BLACKSBURG, VA 24060-6649
(540) 951-3989
Mailing address
210 PROFESSIONAL PARK DR SE STE 11, BLACKSBURG, VA 24060-6649
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/13/2020
Last updated
01/13/2020
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