| NPI | 1053494260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN RIVES OERTEL Owner 804-520-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 401007706) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2009-03-06 |