| NPI | 1114111747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD CLAUDE DAVIS Owner Dentist 540-908-0651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401008683) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2007-08-27 |