Provider Demographics
NPI:1982007852
Name:ALLEGHANY HIGHLANDS DENTAL CARE, PC
Entity Type:Organization
Organization Name:ALLEGHANY HIGHLANDS DENTAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PLASTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-839-3500
Mailing Address - Street 1:1090 NORTHCHASE PKWY SE
Mailing Address - Street 2:STE 150
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-6405
Mailing Address - Country:US
Mailing Address - Phone:770-916-5031
Mailing Address - Fax:678-247-7966
Practice Address - Street 1:6084 SAM SNEAD HWY
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:VA
Practice Address - Zip Code:24445-2664
Practice Address - Country:US
Practice Address - Phone:540-839-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty