| NPI | 1144641309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY TODD HARVEY President 540-685-0028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401410880) |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2013-12-13 |