| NPI | 1215334545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DAVID KING Owner 540-662-4328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401006546) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2014-12-02 |