| NPI | 1184095358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUJIT K MOHANTY Owner 804-527-1008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401008745) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2015-10-14 |