NPI | 1083802607 |
---|---|
Entity Type | Organization |
Authorized Contact | EDWARD ROSS TESTERMAN Dentist 540-885-1631 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: VA 0401005809) |
Enumeration Date | 2007-10-09 |
Last Update Date | 2007-10-09 |