Organization
IMPACT FAMILY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN EVANS DMD (OWNER)
(540) 655-0170
Entity
Organization
Contact information
Practice address
110 PROFESSIONAL PARK DR SE, BLACKSBURG, VA 24060-6735
(540) 655-0170
Mailing address
110 PROFESSIONAL PARK DR SE, BLACKSBURG, VA 24060-6735
(540) 655-0170
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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