| NPI | 1205027695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH M. KLAMUT President 540-432-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401007080) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2007-08-09 |