| NPI | 1215214267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT EDWARD LENZ Owner 540-433-1060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401410163) |
| Enumeration Date | 2011-11-04 |
| Last Update Date | 2011-11-04 |