| NPI | 1255515367 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | CHRISTIE GOFF Office Manager 434-947-5915  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery | 
| Enumeration Date | 2007-12-26 | 
| Last Update Date | 2007-12-26 |