| NPI | 1073965414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SINA SADEGHI Dentist Owner 434-466-0307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 30595) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401413881) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2016-07-11 |