Organization
JUSTIN N TEBBENKAMP DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN NEIL TEBBENKAMP DDS (OWNER/PRESIDENT)
(540) 961-3279
Entity
Organization
Contact information
Practice address
1305 N MAIN ST, BLACKSBURG, VA 24060-3129
(540) 961-3279
Mailing address
1305 N MAIN ST, BLACKSBURG, VA 24060-3129
(540) 961-3279
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401412219
VA
Other
Enumeration date
10/05/2010
Last updated
10/05/2010
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