| NPI | 1043423676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHELSEA NICOLE SAVAGE Insurance COO Rdinator 540-432-0609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: VA 0401006705) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: VA 0401006427) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2015-03-23 |