| NPI | 1124514203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DOUGLAS ROSS Owner 540-344-9361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401007069) |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2018-07-02 |