| NPI | 1164860839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON SAWYER Owner 804-687-8405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401412529) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2013-06-04 |