Bass & Kamp South Main LLC
NPI #1306486840 in Blacksburg, Virginia
Provider Information
- NPI Number
- 1306486840
- Entity Type
- Organization
- Organization Name
- Bass & Kamp South Main LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Jan 13, 2020
- Last Updated
- Jan 13, 2020
Practice Location
- Address
- 210 PROFESSIONAL PARK DR SE STE 11
- City
- Blacksburg
- State
- Virginia
- ZIP Code
- 24060-6649
- Phone
- (540) 951-3989
Authorized Official
- Name
- DR. JUSTIN NEIL TEBBENKAMP, DDS
- Title
- MEMBER
- Phone
- (540) 838-5050
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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