Provider Demographics
NPI:1851449912
Name:TILL, LINDA GARBACIK (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:GARBACIK
Last Name:TILL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3090 ELECTRIC RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3531
Mailing Address - Country:US
Mailing Address - Phone:540-772-3940
Mailing Address - Fax:540-772-3974
Practice Address - Street 1:3090 ELECTRIC RD
Practice Address - Street 2:SUITE A
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3531
Practice Address - Country:US
Practice Address - Phone:540-772-3940
Practice Address - Fax:540-772-3974
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA73531223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics