| NPI | 1154467249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L. WOODSIDE Dentist 540-341-0014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401411006) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2008-06-16 |