| NPI | 1154837292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY HERRON MOODY Dentist/Sole Mbr 804-979-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TN 10324) |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2017-12-27 |