Vista Ridge Dental Arts Studio, LLC
NPI #1154837292 in Johnson City, Tennessee
Provider Information
- NPI Number
- 1154837292
- Entity Type
- Organization
- Organization Name
- Vista Ridge Dental Arts Studio, LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Dec 27, 2017
- Last Updated
- Dec 27, 2017
Practice Location
- Address
- 108 W 10TH AVE
- City
- Johnson City
- State
- Tennessee
- ZIP Code
- 37604-3800
- Phone
- (423) 979-1800
Authorized Official
- Name
- DR. AMY HERRON MOODY, DDS
- Title
- DENTIST/SOLE MBR
- Phone
- (804) 979-1800
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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