Provider Demographics
NPI:1457815573
Name:ADAM C PLASTER DDS PC II
Entity Type:Organization
Organization Name:ADAM C PLASTER DDS PC II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-912-0177
Mailing Address - Street 1:13245 BOOKER T WASHINGTON HWY STE D
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:VA
Mailing Address - Zip Code:24101-3981
Mailing Address - Country:US
Mailing Address - Phone:540-912-0177
Mailing Address - Fax:540-912-0179
Practice Address - Street 1:13245 BOOKER T WASHINGTON HWY STE D
Practice Address - Street 2:
Practice Address - City:HARDY
Practice Address - State:VA
Practice Address - Zip Code:24101-3981
Practice Address - Country:US
Practice Address - Phone:540-912-0177
Practice Address - Fax:540-912-0179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental