| NPI | 1134240237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONI LYNN ROGERS Insurance Coordinator 804-320-2009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401007740) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |