| NPI | 1053585844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERINDA HAMBLIN President 540-801-0150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401410732) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2008-04-14 |