NPI | 1023466513 |
---|---|
Entity Type | Organization |
Authorized Contact | AARON EUGENE QUITMEYER Owner/CEO 540-433-1751 |
Organization Subpart ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: VA 0438000361) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401415056) |
Enumeration Date | 2016-05-25 |
Last Update Date | 2022-07-21 |