| NPI | 1033384052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALF RONALD HENDRICKSEN President 540-587-5707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 04426) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2008-07-15 |