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Individual

DR. JOHN SCOTT REPASS SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
102 HIGHLAND AVE SE, 301 COMMUNITY MEDICAL BLDG, ROANOKE, VA 24013-2253
(540) 343-1769
(540) 342-1606
Mailing address
102 HIGHLAND AVE SE, 301 COMMUNITY MEDICAL BLDG, ROANOKE, VA 24013-2253
(540) 343-1769
(540) 342-1606

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401003883
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
3883
VA

Other

Enumeration date
07/29/2007
Last updated
07/29/2007
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