| NPI | 1235453457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM C BIGELOW Owner 540-213-8750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0438000074) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2010-03-17 |