Drs Brock, Henderson, Di Prisco, Ravelo and Green INC

NPI #1720734684 in Vinton, Virginia

Provider Information

NPI Number: 1720734684
Entity Type: Organization
Organization Name: Drs Brock, Henderson, Di Prisco, Ravelo and Green INC
Subpart: Yes (part of a larger organization)
Parent Organization: DRS KRAJEKIAN,BROCK,HENDERSON & DIPRISCO INC
Primary Specialty: Dentist - Oral and Maxillofacial Surgery
Enumeration Date: Mar 1, 2022
Last Updated: May 30, 2025

Practice Location

Address: 895 E WASHINGTON AVE
City: Vinton
State: Virginia
ZIP Code: 24179-2105
Phone: (304) 425-8220

Authorized Official

Name: LESLEY MARIE COYNER
Title: CREDENTIALING
Phone: (304) 720-7819

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X	Primary

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Drs Green & Henderson INC	Dentist - Oral and Maxillofacial Surgery	Vinton	AI Deep Dive

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