| NPI | 1205293081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELDON BATES President 804-477-4210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401413495) |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2016-01-25 |