| NPI | 1093891806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA H STEVENS Business Manager 276-781-7450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: VA 0401003521) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-08-22 |