Provider Demographics
NPI:1255103198
Name:SEAN ESCHENBACH, DDS, PLLC
Entity type:Organization
Organization Name:SEAN ESCHENBACH, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:ESCHENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-366-5373
Mailing Address - Street 1:6027 PETERS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-4029
Mailing Address - Country:US
Mailing Address - Phone:540-366-5373
Mailing Address - Fax:
Practice Address - Street 1:6027 PETERS CREEK RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-4029
Practice Address - Country:US
Practice Address - Phone:540-366-5373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty