Organization
KEVIN M ALLRED DDS PC
Active
Other names
Powell Valley Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA ALLRED (SECRETARY)
(760) 807-6632
Entity
Organization
Contact information
Practice address
407 3RD AVE E, BIG STONE GAP, VA 24219-2365
(276) 523-0931
(276) 523-0932
Mailing address
407 3RD AVE E, BIG STONE GAP, VA 24219-2365
(276) 523-0931
(276) 523-0932
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679834287
DENTAL
VA
Enumeration date
02/22/2021
Last updated
08/05/2021
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